Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $52.48 / $75.86	Professional		$41.69	$52.48	$75.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $21.38	Professional	26	$12.02	$15.14	$21.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $34.67 / $53.70	Professional	TC	$28.84	$34.67	$53.70
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $46.77 / $61.66	Professional		$21.38	$46.77	$61.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $14.45 / $19.50	Professional	26	$12.88	$14.45	$19.50
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $32.36 / $44.67	Professional	TC	$32.36	$32.36	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $67.61 / $125.89	Professional		$41.69	$67.61	$125.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $19.50 / $34.67	Professional	26	$13.18	$19.50	$34.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $48.98 / $85.11	Professional	TC	$28.84	$48.98	$85.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $45.71 / $89.13	Professional		$37.15	$45.71	$89.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.45 / $24.55	Professional	26	$12.02	$14.45	$24.55
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $31.62 / $63.10	Professional	TC	$25.12	$31.62	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $63.10 / $95.50	Professional		$44.67	$63.10	$95.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.98 / $27.54	Professional	26	$12.88	$16.98	$27.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $44.67 / $69.18	Professional	TC	$31.62	$44.67	$69.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $45.71 / $66.07	Professional		$42.66	$45.71	$66.07
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $14.45 / $20.89	Professional	26	$13.80	$14.45	$20.89
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $30.90 / $44.67	Professional	TC	$28.84	$30.90	$44.67