Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.29 / $15.94 / $18.87	Facility	26	$13.29	$15.94	$18.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $55.96 / $261.05	Professional		$46.77	$55.96	$261.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.29 / $15.82 / $53.55	Professional	26	$13.29	$15.82	$53.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.47 / $38.79 / $89.22	Professional	TC	$32.47	$38.79	$89.22
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $52.31 / $58.12 / $66.43	Professional		$52.31	$58.12	$66.43
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.40 / $17.11 / $19.55	Professional	26	$15.40	$17.11	$19.55
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $36.90 / $41.01 / $46.88	Professional	TC	$36.90	$41.01	$46.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.05 / $61.05 / $110.90	Professional		$42.05	$61.05	$110.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.06 / $18.05 / $34.88	Professional	26	$12.06	$18.05	$34.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.00 / $43.60 / $83.38	Professional	TC	$30.00	$43.60	$83.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.37 / $63.84 / $91.51	Professional		$54.37	$63.84	$91.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.50 / $17.93 / $26.46	Professional	26	$15.50	$17.93	$26.46
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.78 / $46.21 / $66.64	Professional	TC	$38.78	$46.21	$66.64
United Facility/Professional Professional Modifier Low / Median / High Price $41.58 / $51.97 / $91.24	Professional		$41.58	$51.97	$91.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.03 / $16.60 / $32.03	Professional	26	$12.03	$16.60	$32.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.77 / $35.36 / $62.92	Professional	TC	$28.77	$35.36	$62.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.53 / $59.11 / $77.27	Professional		$40.53	$59.11	$77.27
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.62 / $16.55 / $22.58	Professional	26	$11.62	$16.55	$22.58
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $28.91 / $42.79 / $54.71	Professional	TC	$28.91	$42.79	$54.71