Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.41 / $56.34 / $71.79	Facility		$53.41	$56.34	$71.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.36 / $29.98 / $136.81	Professional		$23.36	$29.98	$136.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.25 / $5.65 / $30.64	Professional	26	$4.25	$5.65	$30.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $25.73 / $120.37	Professional	TC	$17.14	$25.73	$120.37
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $31.19 / $31.19 / $39.61	Professional		$31.19	$31.19	$39.61
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.52 / $7.76 / $22.87	Professional	26	$7.52	$7.76	$22.87
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.09 / $23.43 / $29.99	Professional	TC	$21.09	$23.43	$29.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.29 / $19.51 / $58.50	Professional		$14.29	$19.51	$58.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.08 / $3.78 / $10.79	Professional	26	$0.08	$3.78	$10.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.31 / $14.54 / $39.79	Professional	TC	$0.31	$14.54	$39.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.78 / $41.77 / $59.92	Professional		$34.78	$41.77	$59.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.80 / $8.21 / $14.92	Professional	26	$6.80	$8.21	$14.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.97 / $33.92 / $51.80	Professional	TC	$27.97	$33.92	$51.80
United Facility/Professional Professional Modifier Low / Median / High Price $22.54 / $32.50 / $62.61	Professional		$22.54	$32.50	$62.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.23 / $5.78 / $14.02	Professional	26	$4.23	$5.78	$14.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.72 / $25.22 / $51.24	Professional	TC	$17.72	$25.22	$51.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.58 / $43.67 / $49.36	Professional		$30.58	$43.67	$49.36
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.83 / $8.21 / $9.81	Professional	26	$6.83	$8.21	$9.81
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $23.75 / $35.47 / $40.09	Professional	TC	$23.75	$35.47	$40.09