Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.46 / $60.57 / $134.38	Professional		$42.46	$60.57	$134.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.93 / $26.03 / $82.30	Professional	26	$22.93	$26.03	$82.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.67 / $33.58 / $58.46	Professional	TC	$16.67	$33.58	$58.46
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $56.52 / $62.80 / $98.60	Professional		$56.52	$62.80	$98.60
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $25.14 / $25.14 / $35.45	Professional	26	$25.14	$25.14	$35.45
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $37.65 / $37.65 / $53.10	Professional	TC	$37.65	$37.65	$53.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.55 / $68.55 / $177.69	Professional		$47.55	$68.55	$177.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.03 / $34.28 / $74.63	Professional	26	$24.03	$34.28	$74.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.39 / $33.95 / $100.48	Professional	TC	$19.39	$33.95	$100.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.84 / $68.84 / $98.75	Professional		$54.84	$68.84	$98.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.31 / $28.73 / $42.00	Professional	26	$22.31	$28.73	$42.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.46 / $40.21 / $58.98	Professional	TC	$31.46	$40.21	$58.98
United Facility/Professional Professional Modifier Low / Median / High Price $41.13 / $57.55 / $102.73	Professional		$41.13	$57.55	$102.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.66 / $28.97 / $48.17	Professional	26	$21.66	$28.97	$48.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.84 / $27.08 / $48.51	Professional	TC	$16.84	$27.08	$48.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.81 / $48.59 / $86.60	Professional		$36.81	$48.59	$86.60
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $15.17 / $20.43 / $36.33	Professional	26	$15.17	$20.43	$36.33
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $21.64 / $28.16 / $50.27	Professional	TC	$21.64	$28.16	$50.27