Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.52 / $62.46 / $271.32	Professional		$51.52	$62.46	$271.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.98 / $36.07 / $151.35	Professional	26	$20.98	$36.07	$151.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.39 / $36.72 / $128.74	Professional	TC	$26.39	$36.72	$128.74
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $78.41 / $79.92 / $117.73	Professional		$78.41	$79.92	$117.73
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $29.22 / $30.71 / $67.62	Professional	26	$29.22	$30.71	$67.62
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $44.27 / $49.21 / $60.78	Professional	TC	$44.27	$49.21	$60.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.16 / $40.88 / $162.10	Professional		$29.16	$40.88	$162.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.57 / $15.94 / $70.52	Professional	26	$11.57	$15.94	$70.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $24.52 / $79.47	Professional	TC	$17.57	$24.52	$79.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.88 / $83.39 / $109.92	Professional		$69.88	$83.39	$109.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $32.29 / $41.46	Professional	26	$26.92	$32.29	$41.46
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $42.96 / $51.55 / $68.76	Professional	TC	$42.96	$51.55	$68.76
United Facility/Professional Professional Modifier Low / Median / High Price $48.17 / $70.28 / $149.75	Professional		$48.17	$70.28	$149.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.07 / $30.13 / $57.61	Professional	26	$19.07	$30.13	$57.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.06 / $34.83 / $78.11	Professional	TC	$27.06	$34.83	$78.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.73 / $87.18 / $99.91	Professional		$66.73	$87.18	$99.91
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.70 / $32.65 / $39.29	Professional	26	$27.70	$32.65	$39.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $39.04 / $54.53 / $61.65	Professional	TC	$39.04	$54.53	$61.65