Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $89.13 / $204.17	Professional		$69.18	$89.13	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $48.98 / $141.25	Professional	26	$38.02	$48.98	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $42.66 / $81.28	Professional	TC	$23.99	$42.66	$81.28
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $91.20 / $123.03	Professional		$54.95	$91.20	$123.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $42.66 / $58.88	Professional	26	$38.90	$42.66	$58.88
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $48.98 / $66.07	Professional	TC	$43.65	$48.98	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $97.72 / $190.55	Professional		$72.44	$97.72	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $56.23 / $100.00	Professional	26	$38.90	$56.23	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $41.69 / $100.00	Professional	TC	$27.54	$41.69	$100.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $93.33 / $141.25	Professional		$77.62	$93.33	$141.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $44.67 / $70.79	Professional	26	$37.15	$44.67	$70.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $50.12 / $69.18	Professional	TC	$39.81	$50.12	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $87.10 / $141.25	Professional		$63.10	$87.10	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $50.12 / $77.62	Professional	26	$37.15	$50.12	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $36.31 / $64.57	Professional	TC	$23.99	$36.31	$64.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $93.33 / $134.90	Professional		$58.88	$93.33	$134.90
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $44.67 / $63.10	Professional	26	$28.18	$44.67	$63.10
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $50.12 / $72.44	Professional	TC	$30.20	$50.12	$72.44