Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $71.48 / $287.00	Professional		$53.00	$71.48	$287.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.92 / $39.15 / $98.80	Professional	26	$30.92	$39.15	$98.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.10 / $29.29 / $66.09	Professional	TC	$21.10	$29.29	$66.09
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $44.21 / $59.52 / $92.64	Professional		$44.21	$59.52	$92.64
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $27.42 / $33.15 / $61.98	Professional	26	$27.42	$33.15	$61.98
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $18.88 / $26.37 / $35.40	Professional	TC	$18.88	$26.37	$35.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.24 / $67.68 / $125.92	Professional		$47.24	$67.68	$125.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.58 / $40.71 / $74.33	Professional	26	$27.58	$40.71	$74.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.88 / $28.62 / $54.75	Professional	TC	$19.88	$28.62	$54.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.03 / $74.15 / $116.01	Professional		$60.03	$74.15	$116.01
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.93 / $40.96 / $60.77	Professional	26	$33.93	$40.96	$60.77
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.87 / $33.19 / $58.37	Professional	TC	$26.87	$33.19	$58.37
United Facility/Professional Professional Modifier Low / Median / High Price $41.08 / $54.91 / $103.02	Professional		$41.08	$54.91	$103.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.11 / $32.17 / $59.21	Professional	26	$25.11	$32.17	$59.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.81 / $22.22 / $38.06	Professional	TC	$14.81	$22.22	$38.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.21 / $70.62 / $93.98	Professional		$51.21	$70.62	$93.98
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $28.78 / $39.01 / $53.58	Professional	26	$28.78	$39.01	$53.58
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.43 / $31.61 / $40.39	Professional	TC	$22.43	$31.61	$40.39