Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.25 / $136.11 / $200.60	Professional		$115.25	$136.11	$200.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $43.79 / $58.49	Professional	26	$40.09	$43.79	$58.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.87 / $86.91 / $127.51	Professional	TC	$72.87	$86.91	$127.51
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $130.22 / $144.69 / $175.09	Professional		$130.22	$144.69	$175.09
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $36.28 / $40.31 / $48.78	Professional	26	$36.28	$40.31	$48.78
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $93.95 / $104.39 / $126.31	Professional	TC	$93.95	$104.39	$126.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.01 / $194.22 / $382.43	Professional		$105.01	$194.22	$382.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.10 / $62.68 / $112.06	Professional	26	$39.10	$62.68	$112.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.81 / $126.96 / $258.17	Professional	TC	$66.81	$126.96	$258.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.33 / $138.75 / $183.05	Professional		$91.33	$138.75	$183.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $48.72 / $66.44	Professional	26	$33.22	$48.72	$66.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $58.12 / $89.11 / $118.33	Professional	TC	$58.12	$89.11	$118.33
United Facility/Professional Professional Modifier Low / Median / High Price $99.60 / $134.75 / $269.91	Professional		$99.60	$134.75	$269.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.57 / $54.47 / $109.74	Professional	26	$36.57	$54.47	$109.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.64 / $92.16 / $163.27	Professional	TC	$60.64	$92.16	$163.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.23 / $138.97 / $173.73	Professional		$112.23	$138.97	$173.73
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $40.82 / $50.93 / $64.31	Professional	26	$40.82	$50.93	$64.31
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $71.42 / $87.53 / $109.41	Professional	TC	$71.42	$87.53	$109.41