Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $15.14 / $17.78	Facility	26	$12.59	$15.14	$17.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.18 / $125.89 / $173.78	Facility	TC	$28.18	$125.89	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $50.12 / $229.09	Professional		$37.15	$50.12	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $17.78 / $74.13	Professional	26	$12.02	$17.78	$74.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.90 / $67.61	Professional	TC	$22.91	$30.90	$67.61
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $46.77 / $54.95	Professional		$32.36	$46.77	$54.95
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $15.49 / $17.78	Professional	26	$14.13	$15.49	$17.78
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $35.48 / $37.15	Professional	TC	$30.20	$35.48	$37.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $23.99 / $23.99	Facility	26	$23.99	$23.99	$23.99
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $47.86 / $47.86 / $47.86	Facility	TC	$47.86	$47.86	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $48.98 / $91.20	Professional		$34.67	$48.98	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $17.78 / $33.88	Professional	26	$11.22	$17.78	$33.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $30.90 / $69.18	Professional	TC	$22.39	$30.90	$69.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $52.48 / $72.44	Professional		$47.86	$52.48	$72.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $16.98 / $22.91	Professional	26	$15.14	$16.98	$22.91
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $36.31 / $50.12	Professional	TC	$32.36	$36.31	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $45.71 / $81.28	Professional		$34.67	$45.71	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $16.60 / $28.18	Professional	26	$12.59	$16.60	$28.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.84 / $53.70	Professional	TC	$21.88	$28.84	$53.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $54.95 / $75.86	Professional		$36.31	$54.95	$75.86
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $17.78 / $22.39	Professional	26	$11.48	$17.78	$22.39
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $37.15 / $51.29	Professional	TC	$25.12	$37.15	$51.29