Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.65 / $8.65 / $11.78	Facility	26	$8.65	$8.65	$11.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.79 / $37.67 / $142.78	Professional		$30.79	$37.67	$142.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.65 / $10.75 / $26.19	Professional	26	$8.65	$10.75	$26.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.07 / $24.36 / $68.54	Professional	TC	$21.07	$24.36	$68.54
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $36.38 / $40.42 / $45.76	Professional		$36.38	$40.42	$45.76
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.41 / $12.68 / $14.49	Professional	26	$11.41	$12.68	$14.49
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $24.97 / $27.74 / $31.71	Professional	TC	$24.97	$27.74	$31.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.77 / $41.58 / $78.23	Professional		$27.77	$41.58	$78.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.83 / $12.42 / $23.44	Professional	26	$7.83	$12.42	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $29.01 / $57.85	Professional	TC	$19.80	$29.01	$57.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.02 / $43.22 / $61.04	Professional		$36.02	$43.22	$61.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $12.47 / $19.39	Professional	26	$10.11	$12.47	$19.39
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.88 / $30.80 / $43.82	Professional	TC	$25.88	$30.80	$43.82
United Facility/Professional Professional Modifier Low / Median / High Price $28.21 / $34.65 / $60.93	Professional		$28.21	$34.65	$60.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.26 / $11.19 / $18.98	Professional	26	$8.26	$11.19	$18.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.02 / $25.77 / $46.98	Professional	TC	$20.02	$25.77	$46.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.91 / $39.17 / $51.18	Professional		$27.91	$39.17	$51.18
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.86 / $10.80 / $14.73	Professional	26	$7.86	$10.80	$14.73
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $20.05 / $28.52 / $36.46	Professional	TC	$20.05	$28.52	$36.46