Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $54.95 / $151.36	Professional		$42.66	$54.95	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $74.13 / $257.04	Professional	26	$28.84	$74.13	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $21.88 / $51.29	Professional	TC	$14.13	$21.88	$51.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $50.12 / $60.26	Professional		$18.20	$50.12	$60.26
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $34.67 / $41.69	Professional	26	$34.67	$34.67	$41.69
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $18.62 / $23.44	Professional	TC	$16.60	$18.62	$23.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $0.62 / $30.90 / $93.33	Professional		$0.62	$30.90	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.42 / $20.42 / $60.26	Professional	26	$0.42	$20.42	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.22 / $10.47 / $33.11	Professional	TC	$0.22	$10.47	$33.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $66.07 / $87.10	Professional		$56.23	$66.07	$87.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $43.65 / $56.23	Professional	26	$36.31	$43.65	$56.23
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $23.99 / $35.48	Professional	TC	$19.95	$23.99	$35.48
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $46.77 / $100.00	Professional		$37.15	$46.77	$100.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $31.62 / $63.10	Professional	26	$23.44	$31.62	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $16.60 / $32.36	Professional	TC	$12.88	$16.60	$32.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $77.62 / $89.13	Professional		$47.86	$77.62	$89.13
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $50.12 / $56.23	Professional	26	$33.11	$50.12	$56.23
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $28.18 / $32.36	Professional	TC	$14.79	$28.18	$32.36