Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $104.71 / $309.03	Professional		$87.10	$104.71	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $33.88 / $81.28	Professional	26	$25.12	$33.88	$81.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $74.13 / $229.09	Professional	TC	$61.66	$74.13	$229.09
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $97.72 / $141.25	Professional		$30.20	$97.72	$141.25
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $30.20 / $77.62	Professional	26	$26.92	$30.20	$77.62
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $83.18 / $165.96	Professional	TC	$70.79	$83.18	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1.23 / $70.79 / $234.42	Professional		$1.23	$70.79	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.37 / $19.95 / $75.86	Professional	26	$0.37	$19.95	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.89 / $51.29 / $158.49	Professional	TC	$0.89	$51.29	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $134.90 / $173.78	Professional		$112.20	$134.90	$173.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $38.02 / $48.98	Professional	26	$32.36	$38.02	$48.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $95.50 / $128.82	Professional	TC	$79.43	$95.50	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $245.47	Professional		$81.28	$123.03	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $36.31 / $66.07	Professional	26	$23.44	$36.31	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $87.10 / $181.97	Professional	TC	$56.23	$87.10	$181.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $158.49 / $186.21	Professional		$104.71	$158.49	$186.21
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $43.65 / $48.98	Professional	26	$33.11	$43.65	$48.98
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $112.20 / $134.90	Professional	TC	$70.79	$112.20	$134.90