Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.93 / $8.93 / $8.93	Facility	26	$8.93	$8.93	$8.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.35 / $39.88 / $207.00	Professional		$35.35	$39.88	$207.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.93 / $9.98 / $28.30	Professional	26	$8.93	$9.98	$28.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $30.61 / $79.41	Professional	TC	$26.30	$30.61	$79.41
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $40.09 / $43.34 / $55.04	Professional		$40.09	$43.34	$55.04
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $11.50 / $14.61	Professional	26	$10.35	$11.50	$14.61
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.59 / $31.84 / $40.44	Professional	TC	$28.59	$31.84	$40.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.63 / $46.59 / $84.53	Professional		$32.63	$46.59	$84.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.08 / $12.27 / $24.05	Professional	26	$8.08	$12.27	$24.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.89 / $34.54 / $69.26	Professional	TC	$23.89	$34.54	$69.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.44 / $50.17 / $72.69	Professional		$40.44	$50.17	$72.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.43 / $12.45 / $18.80	Professional	26	$10.43	$12.45	$18.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.14 / $38.29 / $55.54	Professional	TC	$30.14	$38.29	$55.54
United Facility/Professional Professional Modifier Low / Median / High Price $30.49 / $40.42 / $69.43	Professional		$30.49	$40.42	$69.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.06 / $11.55 / $19.87	Professional	26	$8.06	$11.55	$19.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.95 / $30.43 / $51.39	Professional	TC	$21.95	$30.43	$51.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $29.40 / $46.45 / $60.55	Professional		$29.40	$46.45	$60.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.22 / $11.17 / $15.23	Professional	26	$7.22	$11.17	$15.23
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.17 / $35.46 / $45.33	Professional	TC	$22.17	$35.46	$45.33