Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $12.88 / $14.79	Facility	26	$10.72	$12.88	$14.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $69.18 / $204.17	Professional		$38.90	$69.18	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $20.42 / $43.65	Professional	26	$10.96	$20.42	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $40.74 / $102.33	Professional	TC	$26.92	$40.74	$102.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $46.77 / $53.70	Professional		$11.75	$46.77	$53.70
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $13.18 / $15.14	Professional	26	$11.75	$13.18	$15.14
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $35.48 / $45.71	Professional	TC	$33.88	$35.48	$45.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $20.42 / $20.42	Facility	26	$20.42	$20.42	$20.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $48.98 / $97.72	Professional		$36.31	$48.98	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $14.13 / $28.18	Professional	26	$9.55	$14.13	$28.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $35.48 / $79.43	Professional	TC	$26.30	$35.48	$79.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $54.95 / $74.13	Professional		$47.86	$54.95	$74.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $14.13 / $19.05	Professional	26	$12.59	$14.13	$19.05
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $40.74 / $56.23	Professional	TC	$35.48	$40.74	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $46.77 / $83.18	Professional		$34.67	$46.77	$83.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.80 / $23.44	Professional	26	$10.00	$13.80	$23.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $33.11 / $61.66	Professional	TC	$24.55	$33.11	$61.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $57.54 / $77.62	Professional		$33.11	$57.54	$77.62
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.79 / $18.62	Professional	26	$8.71	$14.79	$18.62
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $42.66 / $57.54	Professional	TC	$25.12	$42.66	$57.54