Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.23 / $13.47 / $15.32	Facility	26	$11.23	$13.47	$15.32
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.32 / $31.58 / $34.29	Facility	TC	$26.32	$31.58	$34.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.39 / $40.65 / $100.63	Professional		$35.39	$40.65	$100.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $12.98 / $30.09	Professional	26	$11.23	$12.98	$30.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.85 / $27.56 / $70.09	Professional	TC	$22.85	$27.56	$70.09
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $43.33 / $45.95 / $52.51	Professional		$43.33	$45.95	$52.51
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.24 / $15.82 / $18.07	Professional	26	$14.24	$15.82	$18.07
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.07 / $30.13 / $34.44	Professional	TC	$28.07	$30.13	$34.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.08 / $48.53 / $93.60	Professional		$33.08	$48.53	$93.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.16 / $15.72 / $30.46	Professional	26	$10.16	$15.72	$30.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.65 / $32.85 / $65.54	Professional	TC	$22.65	$32.85	$65.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.42 / $52.13 / $74.06	Professional		$43.42	$52.13	$74.06
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.02 / $15.24 / $21.64	Professional	26	$13.02	$15.24	$21.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.19 / $36.49 / $52.45	Professional	TC	$30.19	$36.49	$52.45
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $41.86 / $73.50	Professional		$32.36	$41.86	$73.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.87 / $14.07 / $24.30	Professional	26	$10.87	$14.07	$24.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.34 / $27.16 / $47.43	Professional	TC	$21.34	$27.16	$47.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $34.03 / $47.39 / $62.03	Professional		$34.03	$47.39	$62.03
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.28 / $14.05 / $19.16	Professional	26	$10.28	$14.05	$19.16
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $23.75 / $33.54 / $42.87	Professional	TC	$23.75	$33.54	$42.87