Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.76 / $104.29 / $300.74	Professional		$90.76	$104.29	$300.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.44 / $62.96 / $200.26	Professional	26	$53.44	$62.96	$200.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.48 / $44.10 / $87.78	Professional	TC	$28.48	$44.10	$87.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $99.16 / $110.17 / $172.97	Professional		$99.16	$110.17	$172.97
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $61.57 / $61.57 / $96.66	Professional	26	$61.57	$61.57	$96.66
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $43.75 / $48.61 / $68.54	Professional	TC	$43.75	$48.61	$68.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.05 / $128.52 / $314.76	Professional		$94.05	$128.52	$314.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.64 / $81.91 / $177.93	Professional	26	$57.64	$81.91	$177.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.86 / $46.91 / $130.49	Professional	TC	$31.86	$46.91	$130.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.19 / $122.76 / $182.62	Professional		$97.19	$122.76	$182.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $53.67 / $69.02 / $102.28	Professional	26	$53.67	$69.02	$102.28
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $42.12 / $52.82 / $77.48	Professional	TC	$42.12	$52.82	$77.48
United Facility/Professional Professional Modifier Low / Median / High Price $80.94 / $108.39 / $171.04	Professional		$80.94	$108.39	$171.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.97 / $69.76 / $120.28	Professional	26	$51.97	$69.76	$120.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.13 / $39.99 / $70.31	Professional	TC	$28.13	$39.99	$70.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $77.23 / $86.13 / $153.44	Professional		$77.23	$86.13	$153.44
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $43.40 / $49.14 / $87.42	Professional	26	$43.40	$49.14	$87.42
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $33.83 / $36.99 / $66.03	Professional	TC	$33.83	$36.99	$66.03