Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.73 / $71.98 / $186.17	Professional		$64.73	$71.98	$186.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.10 / $43.26 / $92.20	Professional	26	$33.10	$43.26	$92.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.05 / $34.90 / $69.81	Professional	TC	$21.05	$34.90	$69.81
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $72.20 / $80.23 / $125.96	Professional		$72.20	$80.23	$125.96
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $41.55 / $41.55 / $65.23	Professional	26	$41.55	$41.55	$65.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $34.81 / $38.68 / $54.54	Professional	TC	$34.81	$38.68	$54.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.04 / $87.67 / $221.42	Professional		$66.04	$87.67	$221.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.51 / $52.64 / $112.62	Professional	26	$34.51	$52.64	$112.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.72 / $35.76 / $103.30	Professional	TC	$23.72	$35.76	$103.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.04 / $83.42 / $121.49	Professional		$66.04	$83.42	$121.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.93 / $41.15 / $61.43	Professional	26	$31.93	$41.15	$61.43
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.34 / $41.78 / $61.29	Professional	TC	$33.34	$41.78	$61.29
United Facility/Professional Professional Modifier Low / Median / High Price $54.48 / $73.87 / $126.90	Professional		$54.48	$73.87	$126.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.70 / $43.11 / $65.48	Professional	26	$31.70	$43.11	$65.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.53 / $29.33 / $52.58	Professional	TC	$20.53	$29.33	$52.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.41 / $51.41 / $104.28	Professional		$51.41	$51.41	$104.28
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $25.26 / $52.05	Professional	26	$25.26	$25.26	$52.05
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $26.15 / $26.15 / $52.23	Professional	TC	$26.15	$26.15	$52.23