Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.55 / $46.99 / $73.17	Professional		$42.55	$46.99	$73.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $14.55 / $20.07	Professional	26	$12.80	$14.55	$20.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $33.85 / $52.87	Professional	TC	$29.51	$33.85	$52.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $57.19 / $57.19 / $89.79	Professional		$57.19	$57.19	$89.79
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.45 / $15.45 / $24.26	Professional	26	$15.45	$15.45	$24.26
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $41.74 / $41.74 / $65.53	Professional	TC	$41.74	$41.74	$65.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.87 / $69.67 / $143.52	Professional		$43.87	$69.67	$143.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.60 / $19.89 / $42.59	Professional	26	$13.60	$19.89	$42.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.06 / $50.19 / $99.02	Professional	TC	$30.06	$50.19	$99.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $48.82 / $90.75	Professional		$38.65	$48.82	$90.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $15.86 / $24.34	Professional	26	$12.28	$15.86	$24.34
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.12 / $33.36 / $64.81	Professional	TC	$26.12	$33.36	$64.81
United Facility/Professional Professional Modifier Low / Median / High Price $44.48 / $59.57 / $90.98	Professional		$44.48	$59.57	$90.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $16.44 / $25.27	Professional	26	$12.42	$16.44	$25.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.79 / $42.18 / $68.02	Professional	TC	$31.79	$42.18	$68.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.81 / $42.81 / $61.02	Professional		$42.81	$42.81	$61.02
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.79 / $13.79 / $20.13	Professional	26	$13.79	$13.79	$20.13
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $29.02 / $31.99 / $40.89	Professional	TC	$29.02	$31.99	$40.89