Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.51 / $15.71 / $22.90	Facility	26	$11.51	$15.71	$22.90
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.11 / $37.04 / $140.25	Facility	TC	$28.11	$37.04	$140.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.61 / $47.25 / $141.80	Professional		$39.61	$47.25	$141.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.51 / $15.90 / $66.88	Professional	26	$11.51	$15.90	$66.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.81 / $30.94 / $88.19	Professional	TC	$26.81	$30.94	$88.19
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $46.11 / $51.23 / $58.11	Professional		$46.11	$51.23	$58.11
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $16.41 / $18.23 / $20.84	Professional	26	$16.41	$18.23	$20.84
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $29.70 / $33.00 / $39.04	Professional	TC	$29.70	$33.00	$39.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.85 / $54.87 / $100.87	Professional		$35.85	$54.87	$100.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.44 / $17.94 / $35.11	Professional	26	$10.44	$17.94	$35.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.36 / $38.88 / $73.98	Professional	TC	$25.36	$38.88	$73.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.35 / $55.62 / $84.14	Professional		$46.35	$55.62	$84.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.48 / $17.32 / $28.23	Professional	26	$13.48	$17.32	$28.23
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.85 / $39.14 / $56.16	Professional	TC	$32.85	$39.14	$56.16
United Facility/Professional Professional Modifier Low / Median / High Price $37.06 / $48.46 / $79.14	Professional		$37.06	$48.46	$79.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.67 / $14.80 / $26.21	Professional	26	$11.67	$14.80	$26.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.83 / $34.31 / $64.73	Professional	TC	$24.83	$34.31	$64.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.08 / $50.43 / $65.95	Professional		$37.08	$50.43	$65.95
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $14.41 / $19.64	Professional	26	$10.80	$14.41	$19.64
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $26.28 / $36.24 / $46.32	Professional	TC	$26.28	$36.24	$46.32