Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.84 / $80.50 / $296.02	Professional		$54.84	$80.50	$296.02
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $81.93 / $81.93 / $81.93	Professional	25	$81.93	$81.93	$81.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.42 / $28.69 / $68.01	Professional	26	$22.42	$28.69	$68.01
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.04 / $30.60 / $40.25	Professional	52	$26.04	$30.60	$40.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.66 / $43.68 / $116.13	Professional	TC	$29.66	$43.68	$116.13
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $64.06 / $64.06 / $148.59	Professional		$64.06	$64.06	$148.59
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $18.79 / $26.60 / $40.65	Professional	26	$18.79	$26.60	$40.65
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $37.47 / $37.47 / $118.85	Professional	TC	$37.47	$37.47	$118.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.56 / $76.89 / $134.05	Professional		$48.56	$76.89	$134.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.20 / $29.77 / $54.30	Professional	26	$20.20	$29.77	$54.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.77 / $44.24 / $73.17	Professional	TC	$27.77	$44.24	$73.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.07 / $74.20 / $113.00	Professional		$60.07	$74.20	$113.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.59 / $29.68 / $48.90	Professional	26	$24.59	$29.68	$48.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $36.04 / $44.52 / $71.19	Professional	TC	$36.04	$44.52	$71.19
United Facility/Professional Professional Modifier Low / Median / High Price $48.11 / $61.20 / $106.11	Professional		$48.11	$61.20	$106.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.38 / $23.72 / $43.19	Professional	26	$18.38	$23.72	$43.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.87 / $40.24 / $60.85	Professional	TC	$28.87	$40.24	$60.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.74 / $70.67 / $93.03	Professional		$56.74	$70.67	$93.03
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.25 / $28.27 / $38.82	Professional	26	$23.25	$28.27	$38.82
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $33.49 / $42.40 / $54.21	Professional	TC	$33.49	$42.40	$54.21