Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.92 / $14.92 / $21.75	Facility	26	$10.92	$14.92	$21.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.23 / $45.21 / $153.86	Professional		$29.23	$45.21	$153.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.10 / $14.90 / $57.37	Professional	26	$11.10	$14.90	$57.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.12 / $29.30 / $77.23	Professional	TC	$24.12	$29.30	$77.23
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $42.25 / $44.23 / $50.56	Professional		$42.25	$44.23	$50.56
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.69 / $14.10 / $16.12	Professional	26	$12.69	$14.10	$16.12
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.77 / $30.13 / $34.44	Professional	TC	$28.77	$30.13	$34.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.36 / $47.59 / $95.63	Professional		$33.36	$47.59	$95.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.89 / $14.99 / $29.66	Professional	26	$9.89	$14.99	$29.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.86 / $32.70 / $66.29	Professional	TC	$22.86	$32.70	$66.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.54 / $51.18 / $73.45	Professional		$42.54	$51.18	$73.45
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.79 / $15.17 / $22.94	Professional	26	$12.79	$15.17	$22.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.83 / $36.63 / $52.45	Professional	TC	$28.83	$36.63	$52.45
United Facility/Professional Professional Modifier Low / Median / High Price $31.48 / $41.50 / $72.84	Professional		$31.48	$41.50	$72.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.17 / $14.42 / $23.39	Professional	26	$10.17	$14.42	$23.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.54 / $27.16 / $49.46	Professional	TC	$21.54	$27.16	$49.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.81 / $47.39 / $62.03	Professional		$30.81	$47.39	$62.03
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.06 / $13.68 / $18.66	Professional	26	$9.06	$13.68	$18.66
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $21.75 / $33.92 / $43.37	Professional	TC	$21.75	$33.92	$43.37