Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.64 / $183.03 / $501.72	Professional		$107.64	$183.03	$501.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.09 / $65.76 / $168.78	Professional	26	$53.09	$65.76	$168.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.55 / $109.25 / $330.42	Professional	TC	$54.55	$109.25	$330.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $133.61 / $142.04 / $227.70	Professional		$133.61	$142.04	$227.70
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $59.11 / $65.67 / $74.20	Professional	26	$59.11	$65.67	$74.20
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $69.43 / $76.37 / $165.93	Professional	TC	$69.43	$76.37	$165.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.55 / $187.12 / $298.54	Professional		$114.55	$187.12	$298.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.55 / $79.34 / $128.37	Professional	26	$54.55	$79.34	$128.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.58 / $103.87 / $191.25	Professional	TC	$56.58	$103.87	$191.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.07 / $154.88 / $255.28	Professional		$120.07	$154.88	$255.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.32 / $75.34 / $110.57	Professional	26	$59.32	$75.34	$110.57
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $60.75 / $78.37 / $134.94	Professional	TC	$60.75	$78.37	$134.94
United Facility/Professional Professional Modifier Low / Median / High Price $115.30 / $171.27 / $254.73	Professional		$115.30	$171.27	$254.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.62 / $68.61 / $126.20	Professional	26	$48.62	$68.61	$126.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.18 / $96.90 / $178.62	Professional	TC	$58.18	$96.90	$178.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $119.11 / $138.08 / $172.19	Professional		$119.11	$138.08	$172.19
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $58.84 / $68.22 / $86.43	Professional	26	$58.84	$68.22	$86.43
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $60.27 / $69.86 / $87.20	Professional	TC	$60.27	$69.86	$87.20