Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.21 / $12.56 / $18.32	Facility	26	$9.21	$12.56	$18.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.17 / $41.82 / $181.12	Professional		$34.17	$41.82	$181.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.35 / $10.99 / $35.70	Professional	26	$9.35	$10.99	$35.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.52 / $28.31 / $82.62	Professional	TC	$24.52	$28.31	$82.62
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $39.24 / $40.46 / $46.25	Professional		$39.24	$40.46	$46.25
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $11.50 / $13.14	Professional	26	$10.35	$11.50	$13.14
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.88 / $28.96 / $33.11	Professional	TC	$28.88	$28.96	$33.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.28 / $45.25 / $89.47	Professional		$31.28	$45.25	$89.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $12.27 / $24.25	Professional	26	$8.34	$12.27	$24.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.85 / $33.78 / $64.80	Professional	TC	$22.85	$33.78	$64.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.81 / $48.04 / $68.28	Professional		$40.81	$48.04	$68.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.76 / $12.45 / $18.80	Professional	26	$10.76	$12.45	$18.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.49 / $35.79 / $50.61	Professional	TC	$29.49	$35.79	$50.61
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.97 / $68.54	Professional		$30.20	$38.97	$68.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $11.44 / $20.34	Professional	26	$8.27	$11.44	$20.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.10 / $27.55 / $46.86	Professional	TC	$22.10	$27.55	$46.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.27 / $44.48 / $58.08	Professional		$30.27	$44.48	$58.08
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.00 / $11.52 / $15.71	Professional	26	$8.00	$11.52	$15.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.27 / $33.15 / $42.38	Professional	TC	$22.27	$33.15	$42.38