Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.31 / $39.97 / $53.45	Professional		$35.31	$39.97	$53.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.78 / $12.08 / $15.74	Professional	26	$10.78	$12.08	$15.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.17 / $28.34 / $38.28	Professional	TC	$24.17	$28.34	$38.28
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $57.61 / $57.61 / $91.16	Professional		$57.61	$57.61	$91.16
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $16.01 / $16.01 / $25.34	Professional	26	$16.01	$16.01	$25.34
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $41.60 / $41.60 / $65.81	Professional	TC	$41.60	$41.60	$65.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.91 / $13.91 / $13.91	Facility	26	$13.91	$13.91	$13.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.33 / $53.07 / $92.00	Professional		$40.33	$53.07	$92.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $14.93 / $25.72	Professional	26	$11.23	$14.93	$25.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.50 / $38.36 / $64.11	Professional	TC	$28.50	$38.36	$64.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.52 / $52.38 / $71.09	Professional		$40.52	$52.38	$71.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $13.38 / $19.11	Professional	26	$10.68	$13.38	$19.11
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.91 / $38.22 / $51.22	Professional	TC	$29.91	$38.22	$51.22
United Facility/Professional Professional Modifier Low / Median / High Price $34.27 / $45.65 / $75.97	Professional		$34.27	$45.65	$75.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.24 / $13.70 / $21.16	Professional	26	$10.24	$13.70	$21.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.41 / $33.40 / $54.91	Professional	TC	$24.41	$33.40	$54.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.38 / $36.72 / $65.48	Professional		$36.38	$36.72	$65.48
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $9.93 / $17.67	Professional	26	$9.59	$9.93	$17.67
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $26.79 / $26.79 / $47.79	Professional	TC	$26.79	$26.79	$47.79