Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.22 / $39.54 / $102.99	Professional		$34.22	$39.54	$102.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.53 / $14.22 / $24.40	Professional	26	$12.53	$14.22	$24.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.18 / $24.89 / $43.45	Professional	TC	$21.18	$24.89	$43.45
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $37.69 / $41.87 / $69.09	Professional		$37.69	$41.87	$69.09
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.74 / $14.74 / $24.32	Professional	26	$14.74	$14.74	$24.32
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $24.42 / $27.13 / $42.87	Professional	TC	$24.42	$27.13	$42.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.25 / $16.25 / $16.25	Facility	26	$16.25	$16.25	$16.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.03 / $47.27 / $83.32	Professional		$36.03	$47.27	$83.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.08 / $17.32 / $29.92	Professional	26	$13.08	$17.32	$29.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.42 / $30.38 / $55.05	Professional	TC	$22.42	$30.38	$55.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.53 / $45.93 / $65.44	Professional		$35.53	$45.93	$65.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.44 / $15.57 / $23.02	Professional	26	$12.44	$15.57	$23.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.13 / $29.56 / $42.42	Professional	TC	$23.13	$29.56	$42.42
United Facility/Professional Professional Modifier Low / Median / High Price $31.28 / $42.69 / $66.61	Professional		$31.28	$42.69	$66.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.24 / $15.24 / $25.28	Professional	26	$11.24	$15.24	$25.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.43 / $26.99 / $45.09	Professional	TC	$19.43	$26.99	$45.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.40 / $32.29 / $57.57	Professional		$31.40	$32.29	$57.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.00 / $11.60 / $20.63	Professional	26	$11.00	$11.60	$20.63
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $20.39 / $20.71 / $36.95	Professional	TC	$20.39	$20.71	$36.95