Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $158.63 / $265.62	Professional		$130.08	$158.63	$265.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.61 / $82.02 / $121.59	Professional	26	$71.61	$82.02	$121.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.39 / $79.62 / $129.97	Professional	TC	$51.39	$79.62	$129.97
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $155.32 / $172.58 / $215.73	Professional		$155.32	$172.58	$215.73
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $78.01 / $86.68 / $108.35	Professional	26	$78.01	$86.68	$108.35
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $77.31 / $85.90 / $102.22	Professional	TC	$77.31	$85.90	$102.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.17 / $182.68 / $349.48	Professional		$111.17	$182.68	$349.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.06 / $111.95 / $205.13	Professional	26	$71.06	$111.95	$205.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.18 / $112.61 / $223.04	Professional	TC	$57.18	$112.61	$223.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $119.05 / $174.60 / $238.10	Professional		$119.05	$174.60	$238.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.15 / $88.22 / $120.30	Professional	26	$60.15	$88.22	$120.30
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $56.39 / $86.75 / $117.80	Professional	TC	$56.39	$86.75	$117.80
United Facility/Professional Professional Modifier Low / Median / High Price $98.97 / $164.12 / $335.37	Professional		$98.97	$164.12	$335.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.83 / $84.96 / $157.94	Professional	26	$63.83	$84.96	$157.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.50 / $85.37 / $174.57	Professional	TC	$32.50	$85.37	$174.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $137.66 / $181.85 / $227.31	Professional		$137.66	$181.85	$227.31
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $69.56 / $92.23 / $116.41	Professional	26	$69.56	$92.23	$116.41
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $68.11 / $88.72 / $110.90	Professional	TC	$68.11	$88.72	$110.90