Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $87.10 / $125.89	Professional		$75.86	$87.10	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $44.67 / $81.28	Professional	26	$39.81	$44.67	$81.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $41.69 / $58.88	Professional	TC	$34.67	$41.69	$58.88
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $77.62 / $95.50	Professional		$40.74	$77.62	$95.50
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $36.31 / $47.86	Professional	26	$36.31	$36.31	$47.86
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $45.71 / $48.98	Professional	TC	$40.74	$45.71	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $104.71 / $194.98	Professional		$74.13	$104.71	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $56.23 / $102.33	Professional	26	$39.81	$56.23	$102.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $51.29 / $107.15	Professional	TC	$26.92	$51.29	$107.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $102.33 / $144.54	Professional		$70.79	$102.33	$144.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $47.86 / $69.18	Professional	26	$34.67	$47.86	$69.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $53.70 / $74.13	Professional	TC	$37.15	$53.70	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $93.33 / $177.83	Professional		$61.66	$93.33	$177.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $52.48 / $93.33	Professional	26	$36.31	$52.48	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $41.69 / $85.11	Professional	TC	$21.88	$41.69	$85.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $109.65 / $138.04	Professional		$67.61	$109.65	$138.04
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $52.48 / $66.07	Professional	26	$33.11	$52.48	$66.07
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $57.54 / $72.44	Professional	TC	$33.88	$57.54	$72.44