Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $93.33 / $208.93	Professional		$66.07	$93.33	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $48.98 / $169.82	Professional	26	$38.02	$48.98	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $38.90 / $69.18	Professional	TC	$20.89	$38.90	$69.18
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $77.62 / $114.82	Professional		$39.81	$77.62	$114.82
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $42.66 / $54.95	Professional	26	$38.90	$42.66	$54.95
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $43.65 / $61.66	Professional	TC	$43.65	$43.65	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $93.33 / $177.83	Professional		$67.61	$93.33	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $53.70 / $95.50	Professional	26	$38.02	$53.70	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $37.15 / $89.13	Professional	TC	$23.99	$37.15	$89.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $89.13 / $134.90	Professional		$72.44	$89.13	$134.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $43.65 / $66.07	Professional	26	$37.15	$43.65	$66.07
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $45.71 / $61.66	Professional	TC	$36.31	$45.71	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $81.28 / $134.90	Professional		$60.26	$81.28	$134.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $48.98 / $77.62	Professional	26	$36.31	$48.98	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $32.36 / $58.88	Professional	TC	$21.88	$32.36	$58.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $89.13 / $128.82	Professional		$53.70	$89.13	$128.82
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $43.65 / $63.10	Professional	26	$27.54	$43.65	$63.10
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $44.67 / $64.57	Professional	TC	$26.92	$44.67	$64.57