Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $77.62 / $190.55	Professional		$64.57	$77.62	$190.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $43.65 / $114.82	Professional	26	$33.11	$43.65	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $36.31 / $70.79	Professional	TC	$19.95	$36.31	$70.79
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $54.95 / $100.00	Professional		$37.15	$54.95	$100.00
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $40.74 / $52.48	Professional	26	$33.88	$40.74	$52.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $51.29 / $61.66	Professional	TC	$38.90	$51.29	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $87.10 / $169.82	Professional		$64.57	$87.10	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $51.29 / $95.50	Professional	26	$33.88	$51.29	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $34.67 / $83.18	Professional	TC	$23.44	$34.67	$83.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $112.20	Professional		$66.07	$81.28	$112.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $38.90 / $61.66	Professional	26	$32.36	$38.90	$61.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $41.69 / $57.54	Professional	TC	$33.88	$41.69	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $75.86 / $123.03	Professional		$54.95	$75.86	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $44.67 / $69.18	Professional	26	$32.36	$44.67	$69.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $30.90 / $54.95	Professional	TC	$20.42	$30.90	$54.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $81.28 / $117.49	Professional		$51.29	$81.28	$117.49
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $38.90 / $54.95	Professional	26	$25.12	$38.90	$54.95
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $41.69 / $61.66	Professional	TC	$26.30	$41.69	$61.66