Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $13.18 / $15.14	Facility	26	$10.96	$13.18	$15.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $46.77 / $154.88	Professional		$16.98	$46.77	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $21.38 / $43.65	Professional	26	$11.75	$21.38	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $39.81 / $89.13	Professional	TC	$23.99	$39.81	$89.13
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $42.66 / $48.98	Professional		$13.49	$42.66	$48.98
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $12.02 / $15.49	Professional	26	$12.02	$12.02	$15.49
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $33.88 / $38.02	Professional	TC	$28.84	$33.88	$38.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $20.89 / $20.89	Facility	26	$20.89	$20.89	$20.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $43.65 / $95.50	Professional		$32.36	$43.65	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.79 / $28.84	Professional	26	$10.00	$14.79	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $30.20 / $67.61	Professional	TC	$22.39	$30.20	$67.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $48.98 / $67.61	Professional		$42.66	$48.98	$67.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $14.45 / $19.95	Professional	26	$12.88	$14.45	$19.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $34.67 / $47.86	Professional	TC	$30.20	$34.67	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $41.69 / $75.86	Professional		$31.62	$41.69	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $13.80 / $23.44	Professional	26	$10.23	$13.80	$23.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $28.18 / $51.29	Professional	TC	$21.38	$28.18	$51.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $51.29 / $69.18	Professional		$30.90	$51.29	$69.18
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $15.14 / $19.50	Professional	26	$9.12	$15.14	$19.50
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $36.31 / $50.12	Professional	TC	$21.88	$36.31	$50.12