Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.50 / $67.23 / $144.08	Professional		$45.50	$67.23	$144.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.19 / $32.50 / $75.25	Professional	26	$27.19	$32.50	$75.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.03 / $34.50 / $57.64	Professional	TC	$18.03	$34.50	$57.64
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $69.76 / $77.51 / $121.69	Professional		$69.76	$77.51	$121.69
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $38.83 / $38.83 / $60.96	Professional	26	$38.83	$38.83	$60.96
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $34.81 / $38.68 / $56.50	Professional	TC	$34.81	$38.68	$56.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.74 / $79.04 / $199.03	Professional		$55.74	$79.04	$199.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.68 / $42.09 / $91.32	Professional	26	$29.68	$42.09	$91.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.01 / $35.24 / $104.23	Professional	TC	$21.01	$35.24	$104.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $62.01 / $78.31 / $113.21	Professional		$62.01	$78.31	$113.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.73 / $35.65 / $52.17	Professional	26	$27.73	$35.65	$52.17
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.39 / $42.18 / $61.88	Professional	TC	$33.39	$42.18	$61.88
United Facility/Professional Professional Modifier Low / Median / High Price $47.36 / $64.37 / $100.53	Professional		$47.36	$64.37	$100.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.56 / $35.86 / $55.48	Professional	26	$26.56	$35.86	$55.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $28.22 / $52.21	Professional	TC	$17.89	$28.22	$52.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.51 / $54.94 / $97.91	Professional		$42.51	$54.94	$97.91
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.27 / $25.40 / $45.18	Professional	26	$19.27	$25.40	$45.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $23.24 / $29.54 / $52.72	Professional	TC	$23.24	$29.54	$52.72