Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.23 / $15.32 / $22.34	Facility	26	$11.23	$15.32	$22.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.39 / $64.50 / $206.54	Professional		$47.39	$64.50	$206.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.68 / $20.12 / $45.05	Professional	26	$11.68	$20.12	$45.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.09 / $40.61 / $113.49	Professional	TC	$34.09	$40.61	$113.49
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $52.31 / $58.13 / $73.83	Professional		$52.31	$58.13	$73.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.40 / $17.12 / $21.74	Professional	26	$15.40	$17.12	$21.74
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $36.90 / $41.01 / $52.08	Professional	TC	$36.90	$41.01	$52.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.18 / $58.97 / $110.11	Professional		$42.18	$58.97	$110.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.18 / $17.01 / $32.90	Professional	26	$10.18	$17.01	$32.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.55 / $44.25 / $91.55	Professional	TC	$30.55	$44.25	$91.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.13 / $66.17 / $92.58	Professional		$56.13	$66.17	$92.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.16 / $16.69 / $26.45	Professional	26	$13.16	$16.69	$26.45
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $40.53 / $51.21 / $70.95	Professional	TC	$40.53	$51.21	$70.95
United Facility/Professional Professional Modifier Low / Median / High Price $41.56 / $52.17 / $90.16	Professional		$41.56	$52.17	$90.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.08 / $14.60 / $26.42	Professional	26	$11.08	$14.60	$26.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.99 / $40.77 / $63.63	Professional	TC	$29.99	$40.77	$63.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.25 / $61.27 / $79.77	Professional		$40.25	$61.27	$79.77
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $14.05 / $19.16	Professional	26	$9.44	$14.05	$19.16
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $30.81 / $47.42 / $60.61	Professional	TC	$30.81	$47.42	$60.61