Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.27 / $105.24 / $435.86	Professional		$95.27	$105.24	$435.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.62 / $76.81 / $187.73	Professional	26	$70.62	$76.81	$187.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.26 / $31.76 / $80.81	Professional	TC	$20.26	$31.76	$80.81
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $124.37 / $130.87 / $232.37	Professional		$124.37	$130.87	$232.37
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $87.48 / $96.98 / $115.61	Professional	26	$87.48	$96.98	$115.61
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $33.90 / $33.90 / $151.04	Professional	TC	$33.90	$33.90	$151.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.69 / $117.23 / $209.99	Professional		$89.69	$117.23	$209.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.30 / $85.06 / $153.74	Professional	26	$64.30	$85.06	$153.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.46 / $30.52 / $55.61	Professional	TC	$21.46	$30.52	$55.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.33 / $120.23 / $240.00	Professional		$97.33	$120.23	$240.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $68.81 / $85.01 / $168.78	Professional	26	$68.81	$85.01	$168.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.51 / $35.22 / $58.00	Professional	TC	$28.51	$35.22	$58.00
United Facility/Professional Professional Modifier Low / Median / High Price $74.20 / $93.48 / $166.87	Professional		$74.20	$93.48	$166.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.75 / $68.76 / $116.08	Professional	26	$58.75	$68.76	$116.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.01 / $24.07 / $44.17	Professional	TC	$15.01	$24.07	$44.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.06 / $114.50 / $154.44	Professional		$87.06	$114.50	$154.44
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $62.29 / $80.95 / $111.57	Professional	26	$62.29	$80.95	$111.57
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.77 / $33.54 / $42.87	Professional	TC	$24.77	$33.54	$42.87