Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.59 / $121.67 / $320.83	Professional		$100.59	$121.67	$320.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.47 / $14.48 / $38.79	Professional	26	$13.47	$14.48	$38.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.23 / $106.25 / $234.18	Professional	TC	$84.23	$106.25	$234.18
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $90.81 / $137.47 / $157.41	Professional		$90.81	$137.47	$157.41
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.32 / $17.76 / $19.29	Professional	26	$15.32	$17.76	$19.29
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $75.48 / $119.10 / $140.44	Professional	TC	$75.48	$119.10	$140.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.87 / $134.74 / $222.28	Professional		$94.87	$134.74	$222.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.50 / $16.29 / $29.03	Professional	26	$12.50	$16.29	$29.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.08 / $120.78 / $198.01	Professional	TC	$80.08	$120.78	$198.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.10 / $158.41 / $227.10	Professional		$117.10	$158.41	$227.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.69 / $16.47 / $29.72	Professional	26	$13.69	$16.47	$29.72
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $104.46 / $141.32 / $203.57	Professional	TC	$104.46	$141.32	$203.57
United Facility/Professional Professional Modifier Low / Median / High Price $71.65 / $95.95 / $175.74	Professional		$71.65	$95.95	$175.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.22 / $12.75 / $22.80	Professional	26	$10.22	$12.75	$22.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.86 / $83.80 / $153.71	Professional	TC	$59.86	$83.80	$153.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $82.40 / $151.40 / $195.09	Professional		$82.40	$151.40	$195.09
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.89 / $15.69 / $21.62	Professional	26	$8.89	$15.69	$21.62
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $73.51 / $135.71 / $173.48	Professional	TC	$73.51	$135.71	$173.48