Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.56 / $74.75 / $166.72	Professional		$60.56	$74.75	$166.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.90 / $18.29 / $29.92	Professional	26	$15.90	$18.29	$29.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.83 / $53.27 / $134.71	Professional	TC	$43.83	$53.27	$134.71
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $72.73 / $80.81 / $154.15	Professional		$72.73	$80.81	$154.15
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.52 / $20.91 / $26.14	Professional	26	$15.52	$20.91	$26.14
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $53.91 / $59.90 / $138.62	Professional	TC	$53.91	$59.90	$138.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.84 / $112.44 / $220.12	Professional		$57.84	$112.44	$220.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.20 / $25.24 / $46.19	Professional	26	$16.20	$25.24	$46.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.71 / $84.23 / $189.52	Professional	TC	$42.71	$84.23	$189.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.40 / $75.38 / $106.06	Professional		$51.40	$75.38	$106.06
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.69 / $20.07 / $27.38	Professional	26	$13.69	$20.07	$27.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $36.08 / $55.51 / $79.27	Professional	TC	$36.08	$55.51	$79.27
United Facility/Professional Professional Modifier Low / Median / High Price $56.50 / $91.80 / $152.22	Professional		$56.50	$91.80	$152.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.20 / $20.14 / $35.43	Professional	26	$14.20	$20.14	$35.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.74 / $75.31 / $141.04	Professional	TC	$42.74	$75.31	$141.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $68.53 / $78.00 / $97.50	Professional		$68.53	$78.00	$97.50
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $18.25 / $20.99 / $26.54	Professional	26	$18.25	$20.99	$26.54
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $50.29 / $56.77 / $70.97	Professional	TC	$50.29	$56.77	$70.97