Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.77 / $104.80 / $410.74	Professional		$89.77	$104.80	$410.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.17 / $35.63 / $146.00	Professional	26	$33.17	$35.63	$146.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.14 / $69.43 / $264.76	Professional	TC	$54.14	$69.43	$264.76
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $125.63 / $125.63 / $162.76	Professional		$125.63	$125.63	$162.76
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $47.93 / $47.93 / $66.92	Professional	26	$47.93	$47.93	$66.92
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $77.70 / $77.70 / $100.54	Professional	TC	$77.70	$77.70	$100.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.88 / $79.08 / $253.59	Professional		$49.88	$79.08	$253.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.12 / $27.38 / $90.06	Professional	26	$18.12	$27.38	$90.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.76 / $50.81 / $163.53	Professional	TC	$31.76	$50.81	$163.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $119.36 / $143.22 / $187.96	Professional		$119.36	$143.22	$187.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.88 / $50.26 / $63.86	Professional	26	$41.88	$50.26	$63.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $77.48 / $92.99 / $124.27	Professional	TC	$77.48	$92.99	$124.27
United Facility/Professional Professional Modifier Low / Median / High Price $87.35 / $111.62 / $253.14	Professional		$87.35	$111.62	$253.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.58 / $38.95 / $83.81	Professional	26	$30.58	$38.95	$83.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.87 / $72.95 / $175.78	Professional	TC	$58.87	$72.95	$175.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $125.76 / $149.07 / $170.84	Professional		$125.76	$149.07	$170.84
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $43.30 / $50.65 / $61.41	Professional	26	$43.30	$50.65	$61.41
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $82.46 / $98.43 / $111.27	Professional	TC	$82.46	$98.43	$111.27