Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.51 / $96.79 / $340.00	Professional		$81.51	$96.79	$340.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.42 / $63.15 / $230.00	Professional	26	$50.42	$63.15	$230.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.10 / $41.25 / $78.37	Professional	TC	$25.10	$41.25	$78.37
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $91.94 / $102.16 / $160.38	Professional		$91.94	$102.16	$160.38
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $56.63 / $56.63 / $88.91	Professional	26	$56.63	$56.63	$88.91
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $40.98 / $45.53 / $64.20	Professional	TC	$40.98	$45.53	$64.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.96 / $118.07 / $291.92	Professional		$84.96	$118.07	$291.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.94 / $73.70 / $164.06	Professional	26	$52.94	$73.70	$164.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.39 / $42.19 / $122.05	Professional	TC	$28.39	$42.19	$122.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.02 / $113.71 / $169.00	Professional		$90.02	$113.71	$169.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $49.45 / $63.63 / $93.74	Professional	26	$49.45	$63.63	$93.74
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $39.29 / $49.28 / $73.42	Professional	TC	$39.29	$49.28	$73.42
United Facility/Professional Professional Modifier Low / Median / High Price $73.61 / $100.34 / $159.54	Professional		$73.61	$100.34	$159.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.28 / $63.11 / $109.96	Professional	26	$46.28	$63.11	$109.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.84 / $35.35 / $63.63	Professional	TC	$24.84	$35.35	$63.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.03 / $79.78 / $142.13	Professional		$66.03	$79.78	$142.13
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.90 / $45.28 / $80.54	Professional	26	$36.90	$45.28	$80.54
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $29.13 / $34.51 / $61.61	Professional	TC	$29.13	$34.51	$61.61