Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.44 / $85.96 / $116.36	Professional		$73.44	$85.96	$116.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.81 / $42.64 / $57.37	Professional	26	$38.81	$42.64	$57.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.78 / $41.64 / $57.36	Professional	TC	$33.78	$41.64	$57.36
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $77.29 / $85.88 / $107.35	Professional		$77.29	$85.88	$107.35
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $36.32 / $40.35 / $50.44	Professional	26	$36.32	$40.35	$50.44
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $40.11 / $45.53 / $54.18	Professional	TC	$40.11	$45.53	$54.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.56 / $116.32 / $230.33	Professional		$70.56	$116.32	$230.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.78 / $61.86 / $112.06	Professional	26	$38.78	$61.86	$112.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.61 / $58.57 / $118.27	Professional	TC	$32.61	$58.57	$118.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.69 / $97.81 / $133.38	Professional		$66.69	$97.81	$133.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.90 / $48.26 / $65.81	Professional	26	$32.90	$48.26	$65.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.32 / $49.73 / $67.59	Professional	TC	$32.32	$49.73	$67.59
United Facility/Professional Professional Modifier Low / Median / High Price $53.61 / $94.09 / $166.69	Professional		$53.61	$94.09	$166.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.25 / $48.96 / $100.86	Professional	26	$35.25	$48.96	$100.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.18 / $41.11 / $85.14	Professional	TC	$22.18	$41.11	$85.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.16 / $101.94 / $127.43	Professional		$67.16	$101.94	$127.43
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.14 / $50.45 / $63.86	Professional	26	$33.14	$50.45	$63.86
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $34.03 / $50.86 / $63.57	Professional	TC	$34.03	$50.86	$63.57