Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.04 / $156.53 / $197.49	Professional		$127.04	$156.53	$197.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $103.46 / $129.07 / $159.74	Professional	TC	$103.46	$129.07	$159.74
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $148.71 / $165.23 / $206.54	Professional		$148.71	$165.23	$206.54
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $127.11 / $141.22 / $176.38	Professional	TC	$127.11	$141.22	$176.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.33 / $194.06 / $394.97	Professional		$89.33	$194.06	$394.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.83 / $171.24 / $342.93	Professional	TC	$100.83	$171.24	$342.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.01 / $202.29 / $275.85	Professional		$131.01	$202.29	$275.85
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.27 / $29.73 / $40.54	Professional	26	$20.27	$29.73	$40.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $112.51 / $173.09 / $235.29	Professional	TC	$112.51	$173.09	$235.29
United Facility/Professional Professional Modifier Low / Median / High Price $89.91 / $150.11 / $260.79	Professional		$89.91	$150.11	$260.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.26 / $123.96 / $264.30	Professional	TC	$70.26	$123.96	$264.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $110.31 / $208.44 / $260.55	Professional		$110.31	$208.44	$260.55
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $94.09 / $177.00 / $221.25	Professional	TC	$94.09	$177.00	$221.25