Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.65 / $15.17 / $17.29	Facility	26	$12.65	$15.17	$17.29
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.41 / $36.65 / $172.57	Facility	TC	$28.41	$36.65	$172.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.03 / $44.43 / $139.19	Professional		$38.03	$44.43	$139.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.65 / $14.49 / $33.90	Professional	26	$12.65	$14.49	$33.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.53 / $28.41 / $76.13	Professional	TC	$23.53	$28.41	$76.13
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $46.72 / $50.37 / $57.58	Professional		$46.72	$50.37	$57.58
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $16.37 / $18.19 / $20.58	Professional	26	$16.37	$18.19	$20.58
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.97 / $32.18 / $36.79	Professional	TC	$28.97	$32.18	$36.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.97 / $52.69 / $100.87	Professional		$35.97	$52.69	$100.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.39 / $18.10 / $33.82	Professional	26	$11.39	$18.10	$33.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.18 / $33.89 / $70.00	Professional	TC	$24.18	$33.89	$70.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.21 / $56.60 / $79.26	Professional		$47.21	$56.60	$79.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.66 / $17.16 / $24.97	Professional	26	$14.66	$17.16	$24.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.27 / $39.00 / $54.30	Professional	TC	$32.27	$39.00	$54.30
United Facility/Professional Professional Modifier Low / Median / High Price $34.63 / $45.41 / $79.73	Professional		$34.63	$45.41	$79.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.48 / $15.93 / $28.17	Professional	26	$12.48	$15.93	$28.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.52 / $28.87 / $61.79	Professional	TC	$21.52	$28.87	$61.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.46 / $51.45 / $67.44	Professional		$36.46	$51.45	$67.44
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.43 / $15.85 / $21.62	Professional	26	$11.43	$15.85	$21.62
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.03 / $35.85 / $45.83	Professional	TC	$25.03	$35.85	$45.83