Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.34 / $80.11 / $204.26	Professional		$66.34	$80.11	$204.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.65 / $45.23 / $145.22	Professional	26	$37.65	$45.23	$145.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.42 / $40.90 / $76.78	Professional	TC	$24.42	$40.90	$76.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $88.15 / $97.95 / $153.78	Professional		$88.15	$97.95	$153.78
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $52.07 / $52.07 / $81.75	Professional	26	$52.07	$52.07	$81.75
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $41.28 / $45.87 / $72.02	Professional	TC	$41.28	$45.87	$72.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.94 / $100.11 / $249.67	Professional		$72.94	$100.11	$249.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.28 / $57.91 / $122.47	Professional	26	$39.28	$57.91	$122.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.86 / $42.52 / $122.99	Professional	TC	$27.86	$42.52	$122.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.95 / $97.21 / $142.91	Professional		$76.95	$97.21	$142.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.47 / $46.94 / $70.59	Professional	26	$36.47	$46.94	$70.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $39.61 / $49.67 / $74.03	Professional	TC	$39.61	$49.67	$74.03
United Facility/Professional Professional Modifier Low / Median / High Price $62.65 / $83.88 / $131.91	Professional		$62.65	$83.88	$131.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.28 / $47.35 / $72.81	Professional	26	$36.28	$47.35	$72.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.18 / $35.22 / $70.98	Professional	TC	$24.18	$35.22	$70.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $58.66 / $68.19 / $121.52	Professional		$58.66	$68.19	$121.52
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $28.23 / $33.40 / $59.42	Professional	26	$28.23	$33.40	$59.42
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $30.43 / $34.79 / $62.09	Professional	TC	$30.43	$34.79	$62.09