Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $57.54 / $100.00	Professional		$52.48	$57.54	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $19.95 / $38.90	Professional	26	$18.20	$19.95	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $38.02 / $63.10	Professional	TC	$33.11	$38.02	$63.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $58.88 / $72.44	Professional		$42.66	$58.88	$72.44
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $22.91 / $26.30	Professional	26	$20.89	$22.91	$26.30
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $38.90 / $48.98	Professional	TC	$38.02	$38.90	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $0.81 / $39.81 / $114.82	Professional		$0.81	$39.81	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.28 / $12.59 / $39.81	Professional	26	$0.28	$12.59	$39.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.52 / $25.70 / $77.62	Professional	TC	$0.52	$25.70	$77.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $81.28 / $104.71	Professional		$67.61	$81.28	$104.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $29.51 / $37.15	Professional	26	$24.55	$29.51	$37.15
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $51.29 / $69.18	Professional	TC	$42.66	$51.29	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $60.26 / $123.03	Professional		$40.74	$60.26	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $22.39 / $41.69	Professional	26	$13.80	$22.39	$41.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.90 / $81.28	Professional	TC	$26.92	$38.90	$81.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $93.33 / $109.65	Professional		$64.57	$93.33	$109.65
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $33.11 / $37.15	Professional	26	$23.44	$33.11	$37.15
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $60.26 / $74.13	Professional	TC	$41.69	$60.26	$74.13