Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.29 / $173.71 / $591.47	Professional		$119.29	$173.71	$591.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.03 / $19.17 / $148.47	Professional	26	$18.03	$19.17	$148.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.66 / $154.01 / $442.99	Professional	TC	$83.66	$154.01	$442.99
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $202.38 / $202.38 / $251.41	Professional		$202.38	$202.38	$251.41
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $26.20 / $26.20 / $56.28	Professional	26	$26.20	$26.20	$56.28
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $164.94 / $176.18 / $217.61	Professional	TC	$164.94	$176.18	$217.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.15 / $106.76 / $297.20	Professional		$64.15	$106.76	$297.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.85 / $14.08 / $62.54	Professional	26	$9.85	$14.08	$62.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.70 / $89.34 / $222.61	Professional	TC	$50.70	$89.34	$222.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $202.67 / $243.20 / $322.52	Professional		$202.67	$243.20	$322.52
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.79 / $27.35 / $34.65	Professional	26	$22.79	$27.35	$34.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $179.88 / $215.86 / $287.88	Professional	TC	$179.88	$215.86	$287.88
United Facility/Professional Professional Modifier Low / Median / High Price $112.78 / $150.03 / $329.35	Professional		$112.78	$150.03	$329.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $27.21 / $52.77	Professional	26	$17.07	$27.21	$52.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.31 / $124.63 / $236.25	Professional	TC	$90.31	$124.63	$236.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $135.24 / $255.79 / $289.16	Professional		$135.24	$255.79	$289.16
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $21.87 / $27.49 / $33.40	Professional	26	$21.87	$27.49	$33.40
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $113.37 / $228.32 / $258.10	Professional	TC	$113.37	$228.32	$258.10