Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.79 / $14.26 / $23.46	Facility	26	$11.79	$14.26	$23.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.88 / $42.87 / $216.00	Professional		$36.88	$42.87	$216.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.69 / $13.39 / $31.59	Professional	26	$11.69	$13.39	$31.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $29.95 / $79.92	Professional	TC	$25.37	$29.95	$79.92
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $43.27 / $45.33 / $57.57	Professional		$43.27	$45.33	$57.57
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $13.06 / $14.51 / $18.43	Professional	26	$13.06	$14.51	$18.43
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $29.87 / $30.82 / $39.14	Professional	TC	$29.87	$30.82	$39.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $49.82 / $98.12	Professional		$34.67	$49.82	$98.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.67 / $15.80 / $30.01	Professional	26	$10.67	$15.80	$30.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.57 / $34.61 / $67.77	Professional	TC	$23.57	$34.61	$67.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.01 / $53.17 / $76.36	Professional		$44.01	$53.17	$76.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.79 / $15.90 / $22.94	Professional	26	$13.79	$15.90	$22.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.22 / $37.47 / $53.68	Professional	TC	$30.22	$37.47	$53.68
United Facility/Professional Professional Modifier Low / Median / High Price $32.57 / $43.67 / $74.79	Professional		$32.57	$43.67	$74.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.16 / $14.57 / $25.86	Professional	26	$10.16	$14.57	$25.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.58 / $30.57 / $68.81	Professional	TC	$22.58	$30.57	$68.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $32.86 / $49.23 / $64.48	Professional		$32.86	$49.23	$64.48
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.03 / $14.76 / $20.13	Professional	26	$10.03	$14.76	$20.13
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.84 / $34.69 / $44.34	Professional	TC	$22.84	$34.69	$44.34