Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $13.49 / $22.39	Facility	26	$11.22	$13.49	$22.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $85.11 / $218.78	Professional		$48.98	$85.11	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $26.30 / $53.70	Professional	26	$12.30	$26.30	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $57.54 / $125.89	Professional	TC	$33.88	$57.54	$125.89
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $51.29 / $69.18	Professional		$13.80	$51.29	$69.18
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.59 / $20.89	Professional	26	$12.30	$12.59	$20.89
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $44.67 / $64.57	Professional	TC	$39.81	$44.67	$64.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.38 / $21.38 / $21.38	Facility	26	$21.38	$21.38	$21.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $109.65	Professional		$40.74	$57.54	$109.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.60 / $32.36	Professional	26	$10.00	$16.60	$32.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $40.74 / $91.20	Professional	TC	$28.84	$40.74	$91.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $64.57 / $89.13	Professional		$57.54	$64.57	$89.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $14.79 / $20.42	Professional	26	$13.49	$14.79	$20.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $50.12 / $67.61	Professional	TC	$42.66	$50.12	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $51.29 / $93.33	Professional		$40.74	$51.29	$93.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $14.45 / $25.12	Professional	26	$11.22	$14.45	$25.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $37.15 / $69.18	Professional	TC	$29.51	$37.15	$69.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $67.61 / $87.10	Professional		$39.81	$67.61	$87.10
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.49 / $19.95	Professional	26	$9.33	$15.49	$19.95
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $52.48 / $67.61	Professional	TC	$30.90	$52.48	$67.61