Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.51 / $180.90 / $342.93	Professional		$117.51	$180.90	$342.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.76 / $22.35 / $61.52	Professional	26	$18.76	$22.35	$61.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.48 / $162.12 / $335.26	Professional	TC	$95.48	$162.12	$335.26
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $143.35 / $159.27 / $232.53	Professional		$143.35	$159.27	$232.53
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.51 / $22.25 / $32.47	Professional	26	$20.51	$22.25	$32.47
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $120.61 / $137.03 / $200.06	Professional	TC	$120.61	$137.03	$200.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.83 / $179.56 / $288.35	Professional		$119.83	$179.56	$288.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.48 / $29.23 / $51.69	Professional	26	$19.48	$29.23	$51.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.40 / $156.63 / $257.02	Professional	TC	$97.40	$156.63	$257.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.90 / $164.99 / $236.47	Professional		$127.90	$164.99	$236.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.16 / $29.85 / $40.42	Professional	26	$23.16	$29.85	$40.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $104.41 / $134.69 / $196.06	Professional	TC	$104.41	$134.69	$196.06
United Facility/Professional Professional Modifier Low / Median / High Price $114.69 / $175.13 / $334.69	Professional		$114.69	$175.13	$334.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.73 / $26.49 / $51.73	Professional	26	$16.73	$26.49	$51.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.91 / $146.97 / $229.74	Professional	TC	$94.91	$146.97	$229.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $127.90 / $147.09 / $181.55	Professional		$127.90	$147.09	$181.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.50 / $27.03 / $33.81	Professional	26	$23.50	$27.03	$33.81
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $104.40 / $120.07 / $149.85	Professional	TC	$104.40	$120.07	$149.85