Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.98 / $127.30 / $542.05	Professional		$100.98	$127.30	$542.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.65 / $33.79 / $163.82	Professional	26	$31.65	$33.79	$163.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.54 / $87.18 / $361.91	Professional	TC	$69.54	$87.18	$361.91
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $121.71 / $135.24 / $220.10	Professional		$121.71	$135.24	$220.10
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.84 / $45.38 / $85.23	Professional	26	$40.84	$45.38	$85.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $80.87 / $89.86 / $134.87	Professional	TC	$80.87	$89.86	$134.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.41 / $78.93 / $340.59	Professional		$61.41	$78.93	$340.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.80 / $23.33 / $96.55	Professional	26	$17.80	$23.33	$96.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.18 / $57.85 / $233.34	Professional	TC	$38.18	$57.85	$233.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $154.44 / $185.33 / $234.46	Professional		$154.44	$185.33	$234.46
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.31 / $49.57 / $63.18	Professional	26	$41.31	$49.57	$63.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $113.13 / $135.76 / $172.46	Professional	TC	$113.13	$135.76	$172.46
United Facility/Professional Professional Modifier Low / Median / High Price $94.02 / $133.88 / $273.43	Professional		$94.02	$133.88	$273.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.47 / $42.03 / $79.06	Professional	26	$28.47	$42.03	$79.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.38 / $92.29 / $194.45	Professional	TC	$66.38	$92.29	$194.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $114.84 / $193.75 / $220.13	Professional		$114.84	$193.75	$220.13
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $37.52 / $50.11 / $60.45	Professional	26	$37.52	$50.11	$60.45
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $77.31 / $143.65 / $162.38	Professional	TC	$77.31	$143.65	$162.38