Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.20 / $99.18 / $99.59	Facility		$86.20	$99.18	$99.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.78 / $38.31 / $174.38	Professional		$30.78	$38.31	$174.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.97 / $12.61 / $54.91	Professional	26	$6.97	$12.61	$54.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.77 / $30.80 / $145.44	Professional	TC	$21.77	$30.80	$145.44
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $41.32 / $41.32 / $52.89	Professional		$41.32	$41.32	$52.89
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.56 / $12.75 / $29.94	Professional	26	$12.56	$12.75	$29.94
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $25.71 / $28.57 / $37.35	Professional	TC	$25.71	$28.57	$37.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.32 / $25.86 / $76.26	Professional		$18.32	$25.86	$76.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.13 / $6.09 / $17.73	Professional	26	$0.13	$6.09	$17.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.37 / $18.98 / $54.92	Professional	TC	$0.37	$18.98	$54.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.37 / $53.24 / $72.69	Professional		$44.37	$53.24	$72.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.17 / $13.52 / $24.54	Professional	26	$11.17	$13.52	$24.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.20 / $40.28 / $54.30	Professional	TC	$33.20	$40.28	$54.30
United Facility/Professional Professional Modifier Low / Median / High Price $29.87 / $43.17 / $75.34	Professional		$29.87	$43.17	$75.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.05 / $9.49 / $22.00	Professional	26	$7.05	$9.49	$22.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.95 / $30.24 / $71.28	Professional	TC	$21.95	$30.24	$71.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.64 / $55.64 / $63.02	Professional		$40.64	$55.64	$63.02
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.42 / $13.52 / $16.20	Professional	26	$11.42	$13.52	$16.20
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $29.22 / $42.11 / $47.61	Professional	TC	$29.22	$42.11	$47.61