Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.70 / $61.80 / $68.66	Professional		$32.70	$61.80	$68.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.12 / $20.26 / $20.83	Professional	26	$15.12	$20.26	$20.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $41.77 / $47.83	Professional	TC	$17.57	$41.77	$47.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $54.67 / $65.31 / $79.03	Professional		$54.67	$65.31	$79.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $21.37 / $22.48 / $28.77	Professional	26	$21.37	$22.48	$28.77
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $29.00 / $42.83 / $54.26	Professional	TC	$29.00	$42.83	$54.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.36 / $39.22 / $99.10	Professional		$24.36	$39.22	$99.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.28 / $13.40 / $38.97	Professional	26	$0.28	$13.40	$38.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.69 / $27.68 / $58.97	Professional	TC	$0.69	$27.68	$58.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.16 / $104.46 / $130.74	Professional		$87.16	$104.46	$130.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.94 / $29.93 / $42.93	Professional	26	$24.94	$29.93	$42.93
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $62.22 / $74.66 / $93.33	Professional	TC	$62.22	$74.66	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $37.61 / $55.72 / $104.48	Professional		$37.61	$55.72	$104.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.73 / $20.96 / $47.43	Professional	26	$15.73	$20.96	$47.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.56 / $34.64 / $64.95	Professional	TC	$21.56	$34.64	$64.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.75 / $109.20 / $124.07	Professional		$57.75	$109.20	$124.07
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $21.93 / $30.29 / $36.36	Professional	26	$21.93	$30.29	$36.36
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $35.82 / $78.91 / $89.21	Professional	TC	$35.82	$78.91	$89.21