Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.60 / $60.44 / $144.51	Professional		$31.60	$60.44	$144.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.34 / $20.85 / $51.15	Professional	26	$15.34	$20.85	$51.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.26 / $40.72 / $78.44	Professional	TC	$16.26	$40.72	$78.44
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $50.39 / $69.37 / $83.94	Professional		$50.39	$69.37	$83.94
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $21.69 / $22.82 / $29.21	Professional	26	$21.69	$22.82	$29.21
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $24.72 / $46.55 / $57.50	Professional	TC	$24.72	$46.55	$57.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.01 / $41.72 / $95.56	Professional		$22.01	$41.72	$95.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.28 / $13.79 / $39.42	Professional	26	$0.28	$13.79	$39.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.67 / $27.63 / $60.26	Professional	TC	$0.67	$27.63	$60.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.46 / $103.61 / $129.69	Professional		$86.46	$103.61	$129.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $30.74 / $51.20	Professional	26	$25.29	$30.74	$51.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $61.17 / $73.40 / $91.76	Professional	TC	$61.17	$73.40	$91.76
United Facility/Professional Professional Modifier Low / Median / High Price $35.97 / $58.03 / $108.81	Professional		$35.97	$58.03	$108.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.00 / $21.66 / $58.18	Professional	26	$16.00	$21.66	$58.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.20 / $37.85 / $86.22	Professional	TC	$20.20	$37.85	$86.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.15 / $108.32 / $123.07	Professional		$62.15	$108.32	$123.07
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.55 / $30.74 / $36.86	Professional	26	$22.55	$30.74	$36.86
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $39.60 / $77.58 / $87.70	Professional	TC	$39.60	$77.58	$87.70