Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $229.09	Professional		$52.48	$70.79	$229.09
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $81.28 / $81.28 / $81.28	Professional	25	$81.28	$81.28	$81.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $28.18 / $79.43	Professional	26	$20.89	$28.18	$79.43
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $51.29 / $70.79 / $125.89	Professional	52	$51.29	$70.79	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $34.67 / $61.66	Professional	TC	$26.92	$34.67	$61.66
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $57.54 / $69.18	Professional		$34.67	$57.54	$69.18
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $25.70 / $28.18	Professional	26	$13.80	$25.70	$28.18
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $46.77 / $52.48	Professional	TC	$38.02	$46.77	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $77.62 / $125.89	Professional		$48.98	$77.62	$125.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $29.51 / $46.77	Professional	26	$20.42	$29.51	$46.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $46.77 / $70.79	Professional	TC	$28.18	$46.77	$70.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $72.44 / $109.65	Professional		$57.54	$72.44	$109.65
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $28.84 / $43.65	Professional	26	$23.44	$28.84	$43.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $43.65 / $66.07	Professional	TC	$33.88	$43.65	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $66.07 / $120.23	Professional		$51.29	$66.07	$120.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $24.55 / $45.71	Professional	26	$18.62	$24.55	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $40.74 / $70.79	Professional	TC	$28.84	$40.74	$70.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $67.61 / $107.15	Professional		$56.23	$67.61	$107.15
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $28.84 / $41.69	Professional	26	$23.44	$28.84	$41.69
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $43.65 / $64.57	Professional	TC	$33.11	$43.65	$64.57