Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.78 / $11.74 / $13.35	Facility	26	$9.78	$11.74	$13.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.07 / $52.43 / $265.00	Professional		$44.07	$52.43	$265.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $11.28 / $31.46	Professional	26	$9.78	$11.28	$31.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.15 / $41.14 / $101.17	Professional	TC	$33.15	$41.14	$101.17
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $49.39 / $56.57 / $64.66	Professional		$49.39	$56.57	$64.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.10 / $13.44 / $15.37	Professional	26	$12.10	$13.44	$15.37
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $36.61 / $43.13 / $49.30	Professional	TC	$36.61	$43.13	$49.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.82 / $56.41 / $109.01	Professional		$41.82	$56.41	$109.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.86 / $13.59 / $26.50	Professional	26	$8.86	$13.59	$26.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.47 / $43.72 / $93.04	Professional	TC	$32.47	$43.72	$93.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.18 / $65.06 / $94.09	Professional		$52.18	$65.06	$94.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.45 / $13.78 / $20.58	Professional	26	$11.45	$13.78	$20.58
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $40.96 / $52.05 / $75.28	Professional	TC	$40.96	$52.05	$75.28
United Facility/Professional Professional Modifier Low / Median / High Price $38.35 / $51.17 / $90.23	Professional		$38.35	$51.17	$90.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $12.63 / $21.68	Professional	26	$9.36	$12.63	$21.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.98 / $40.36 / $70.61	Professional	TC	$28.98	$40.36	$70.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.38 / $60.24 / $78.29	Professional		$38.38	$60.24	$78.29
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.99 / $12.24 / $16.70	Professional	26	$7.99	$12.24	$16.70
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $30.39 / $48.19 / $61.61	Professional	TC	$30.39	$48.19	$61.61