Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.75 / $39.13 / $98.35	Professional		$27.75	$39.13	$98.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.37 / $17.07 / $45.77	Professional	26	$13.37	$17.07	$45.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.18 / $23.32 / $52.55	Professional	TC	$14.18	$23.32	$52.55
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $34.03 / $34.03 / $81.93	Professional		$34.03	$34.03	$81.93
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.92 / $15.67 / $30.39	Professional	26	$12.92	$15.67	$30.39
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $18.37 / $18.37 / $51.54	Professional	TC	$18.37	$18.37	$51.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.65 / $40.90 / $68.66	Professional		$25.65	$40.90	$68.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.73 / $18.12 / $32.24	Professional	26	$11.73	$18.12	$32.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.62 / $22.14 / $38.90	Professional	TC	$13.62	$22.14	$38.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.65 / $39.09 / $77.08	Professional		$31.65	$39.09	$77.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.62 / $17.64 / $31.77	Professional	26	$14.62	$17.64	$31.77
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $17.37 / $21.45 / $42.83	Professional	TC	$17.37	$21.45	$42.83
United Facility/Professional Professional Modifier Low / Median / High Price $27.43 / $38.54 / $58.87	Professional		$27.43	$38.54	$58.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.98 / $14.76 / $25.70	Professional	26	$11.98	$14.76	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.15 / $21.61 / $33.10	Professional	TC	$14.15	$21.61	$33.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.36 / $37.22 / $49.20	Professional		$33.36	$37.22	$49.20
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $15.40 / $16.80 / $23.09	Professional	26	$15.40	$16.80	$23.09
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.97 / $20.43 / $26.10	Professional	TC	$17.97	$20.43	$26.10