Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.45 / $6.40 / $16.17	Professional	26	$5.45	$6.40	$16.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.48 / $20.53 / $35.40	Professional	TC	$17.48	$20.53	$35.40
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $18.62 / $26.25	Professional	26	$18.62	$18.62	$26.25
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $64.44 / $64.44 / $90.86	Professional	TC	$64.44	$64.44	$90.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.53 / $32.99 / $73.83	Professional	26	$23.53	$32.99	$73.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.04 / $111.53 / $255.11	Professional	TC	$75.04	$111.53	$255.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.98 / $25.86 / $35.92	Professional	26	$21.98	$25.86	$35.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $71.47 / $88.28 / $120.00	Professional	TC	$71.47	$88.28	$120.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.10 / $32.46 / $68.50	Professional	26	$18.10	$32.46	$68.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.08 / $136.00 / $236.92	Professional	TC	$74.08	$136.00	$236.92
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.24 / $20.14 / $35.85	Professional	26	$5.24	$20.14	$35.85
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.04 / $61.00 / $112.85	Professional	TC	$17.04	$61.00	$112.85