Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $16.22 / $23.44	Facility	26	$11.75	$16.22	$23.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $51.29 / $199.53	Professional		$36.31	$51.29	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $22.39 / $45.71	Professional	26	$11.75	$22.39	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $32.36 / $79.43	Professional	TC	$23.44	$32.36	$79.43
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $43.65 / $56.23	Professional		$14.45	$43.65	$56.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $13.18 / $25.70	Professional	26	$12.88	$13.18	$25.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $30.90 / $43.65	Professional	TC	$29.51	$30.90	$43.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.39 / $22.39 / $22.39	Facility	26	$22.39	$22.39	$22.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $97.72	Professional		$33.88	$47.86	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $15.49 / $30.20	Professional	26	$10.47	$15.49	$30.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $33.88 / $70.79	Professional	TC	$23.44	$33.88	$70.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $50.12 / $69.18	Professional		$43.65	$50.12	$69.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $15.14 / $20.89	Professional	26	$13.80	$15.14	$20.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $35.48 / $48.98	Professional	TC	$30.20	$35.48	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $43.65 / $79.43	Professional		$33.88	$43.65	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $14.79 / $25.70	Professional	26	$10.23	$14.79	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.90 / $53.70	Professional	TC	$22.91	$30.90	$53.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $52.48 / $70.79	Professional		$33.11	$52.48	$70.79
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.85 / $20.89	Professional	26	$10.00	$15.85	$20.89
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $36.31 / $50.12	Professional	TC	$22.91	$36.31	$50.12