Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.97 / $47.13 / $88.63	Professional		$34.97	$47.13	$88.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.18 / $21.23 / $44.14	Professional	26	$16.18	$21.23	$44.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.33 / $29.81 / $45.65	Professional	TC	$15.33	$29.81	$45.65
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $48.83 / $54.26 / $85.19	Professional		$48.83	$54.26	$85.19
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.36 / $20.36 / $31.97	Professional	26	$20.36	$20.36	$31.97
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $30.51 / $33.90 / $47.80	Professional	TC	$30.51	$33.90	$47.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.15 / $56.57 / $144.69	Professional		$40.15	$56.57	$144.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.92 / $26.67 / $54.53	Professional	26	$16.92	$26.67	$54.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.77 / $30.14 / $90.17	Professional	TC	$17.77	$30.14	$90.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.89 / $56.70 / $83.66	Professional		$44.89	$56.70	$83.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.67 / $20.14 / $30.10	Professional	26	$15.67	$20.14	$30.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.71 / $36.26 / $53.19	Professional	TC	$28.71	$36.26	$53.19
United Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $46.45 / $74.97	Professional		$35.22	$46.45	$74.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.07 / $21.51 / $33.02	Professional	26	$16.07	$21.51	$33.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.33 / $24.34 / $45.63	Professional	TC	$15.33	$24.34	$45.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.61 / $39.75 / $70.88	Professional		$31.61	$39.75	$70.88
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $14.36 / $25.55	Professional	26	$11.14	$14.36	$25.55
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $20.46 / $25.40 / $45.33	Professional	TC	$20.46	$25.40	$45.33