Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.62 / $98.23 / $109.51	Professional		$46.62	$98.23	$109.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.19 / $25.56 / $26.81	Professional	26	$16.19	$25.56	$26.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.43 / $73.11 / $82.69	Professional	TC	$30.43	$73.11	$82.69
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $102.60 / $114.00 / $144.78	Professional		$102.60	$114.00	$144.78
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $31.85 / $35.39 / $44.95	Professional	26	$31.85	$35.39	$44.95
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $70.75 / $78.61 / $99.83	Professional	TC	$70.75	$78.61	$99.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.58 / $65.23 / $139.35	Professional		$31.58	$65.23	$139.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.41 / $16.77 / $43.55	Professional	26	$10.41	$16.77	$43.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.17 / $48.64 / $99.80	Professional	TC	$21.17	$48.64	$99.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $135.52 / $162.62 / $203.28	Professional		$135.52	$162.62	$203.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.28 / $39.94 / $50.91	Professional	26	$33.28	$39.94	$50.91
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $102.24 / $122.69 / $154.26	Professional	TC	$102.24	$122.69	$154.26
United Facility/Professional Professional Modifier Low / Median / High Price $51.73 / $93.26 / $159.63	Professional		$51.73	$93.26	$159.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.45 / $27.14 / $50.88	Professional	26	$16.45	$27.14	$50.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.35 / $65.59 / $108.92	Professional	TC	$35.35	$65.59	$108.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.18 / $170.28 / $193.07	Professional		$97.18	$170.28	$193.07
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $28.10 / $40.38 / $48.64	Professional	26	$28.10	$40.38	$48.64
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $69.08 / $129.90 / $146.85	Professional	TC	$69.08	$129.90	$146.85