Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.92 / $81.51 / $264.75	Professional		$52.92	$81.51	$264.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.20 / $16.71 / $63.66	Professional	26	$14.20	$16.71	$63.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.72 / $64.80 / $194.51	Professional	TC	$38.72	$64.80	$194.51
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $38.11 / $96.76 / $122.89	Professional		$38.11	$96.76	$122.89
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.95 / $23.28 / $29.57	Professional	26	$20.95	$23.28	$29.57
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $11.43 / $73.48 / $93.32	Professional	TC	$11.43	$73.48	$93.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.83 / $47.83 / $131.75	Professional		$36.83	$47.83	$131.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.24 / $11.80 / $35.40	Professional	26	$0.24	$11.80	$35.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.83 / $36.95 / $99.94	Professional	TC	$0.83	$36.95	$99.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $88.99 / $106.79 / $140.80	Professional		$88.99	$106.79	$140.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.45 / $23.34 / $41.79	Professional	26	$19.45	$23.34	$41.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $69.54 / $83.45 / $111.23	Professional	TC	$69.54	$83.45	$111.23
United Facility/Professional Professional Modifier Low / Median / High Price $61.96 / $78.81 / $147.78	Professional		$61.96	$78.81	$147.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.53 / $18.48 / $34.65	Professional	26	$14.53	$18.48	$34.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.25 / $62.41 / $153.52	Professional	TC	$45.25	$62.41	$153.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $80.76 / $111.67 / $126.54	Professional		$80.76	$111.67	$126.54
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.53 / $23.45 / $28.49	Professional	26	$19.53	$23.45	$28.49
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $61.23 / $88.22 / $99.72	Professional	TC	$61.23	$88.22	$99.72