Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $120.23	Professional		$33.88	$42.66	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $39.81	Professional	26	$12.02	$15.14	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $25.12 / $46.77	Professional	TC	$20.89	$25.12	$46.77
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $43.65 / $63.10	Professional		$24.55	$43.65	$63.10
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $14.79 / $22.39	Professional	26	$13.49	$14.79	$22.39
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $28.84 / $41.69	Professional	TC	$26.30	$28.84	$41.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.47 / $16.22 / $22.91	Facility	26	$3.47	$16.22	$22.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $46.77 / $77.62	Professional		$36.31	$46.77	$77.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $16.98 / $28.18	Professional	26	$13.18	$16.98	$28.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $29.51 / $51.29	Professional	TC	$22.39	$29.51	$51.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $47.86 / $66.07	Professional		$38.02	$47.86	$66.07
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $15.49 / $22.39	Professional	26	$12.59	$15.49	$22.39
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $32.36 / $43.65	Professional	TC	$25.12	$32.36	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $43.65 / $75.86	Professional		$31.62	$43.65	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $16.22 / $26.92	Professional	26	$11.75	$16.22	$26.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $28.18 / $48.98	Professional	TC	$19.50	$28.18	$48.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $51.29 / $63.10	Professional		$31.62	$51.29	$63.10
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.98 / $21.38	Professional	26	$10.96	$16.98	$21.38
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $33.88 / $42.66	Professional	TC	$20.42	$33.88	$42.66