Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $15.14 / $17.38	Facility	26	$12.30	$15.14	$17.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $95.50 / $302.00	Professional		$53.70	$95.50	$302.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $28.84 / $63.10	Professional	26	$12.88	$28.84	$63.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $56.23 / $158.49	Professional	TC	$38.02	$56.23	$158.49
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $63.10 / $79.43	Professional		$13.80	$63.10	$79.43
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $15.14 / $20.42	Professional	26	$13.49	$15.14	$20.42
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $50.12 / $74.13	Professional	TC	$48.98	$50.12	$74.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $23.44 / $23.44	Facility	26	$23.44	$23.44	$23.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $69.18 / $138.04	Professional		$48.98	$69.18	$138.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $18.62 / $35.48	Professional	26	$11.22	$18.62	$35.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $51.29 / $112.20	Professional	TC	$36.31	$51.29	$112.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $75.86 / $100.00	Professional		$66.07	$75.86	$100.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $16.60 / $22.39	Professional	26	$14.79	$16.60	$22.39
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $58.88 / $77.62	Professional	TC	$51.29	$58.88	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $61.66 / $109.65	Professional		$48.98	$61.66	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.22 / $28.84	Professional	26	$12.88	$16.22	$28.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $46.77 / $83.18	Professional	TC	$36.31	$46.77	$83.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $77.62 / $102.33	Professional		$50.12	$77.62	$102.33
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $17.38 / $21.88	Professional	26	$11.48	$17.38	$21.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $60.26 / $81.28	Professional	TC	$38.90	$60.26	$81.28