Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.65 / $12.77 / $14.53	Facility	26	$10.65	$12.77	$14.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.10 / $41.76 / $166.40	Professional		$35.10	$41.76	$166.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.65 / $13.27 / $31.55	Professional	26	$10.65	$13.27	$31.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.26 / $29.95 / $72.92	Professional	TC	$23.26	$29.95	$72.92
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $42.50 / $45.84 / $58.22	Professional		$42.50	$45.84	$58.22
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $13.52 / $15.02 / $19.07	Professional	26	$13.52	$15.02	$19.07
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.48 / $30.82 / $39.14	Professional	TC	$27.48	$30.82	$39.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $49.48 / $94.38	Professional		$33.86	$49.48	$94.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $14.95 / $28.92	Professional	26	$9.66	$14.95	$28.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.16 / $33.42 / $67.77	Professional	TC	$23.16	$33.42	$67.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.45 / $53.45 / $73.56	Professional		$44.45	$53.45	$73.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.33 / $14.43 / $20.49	Professional	26	$12.33	$14.43	$20.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.91 / $38.58 / $53.07	Professional	TC	$31.91	$38.58	$53.07
United Facility/Professional Professional Modifier Low / Median / High Price $32.26 / $42.41 / $94.54	Professional		$32.26	$42.41	$94.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.96 / $13.71 / $23.23	Professional	26	$9.96	$13.71	$23.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.78 / $28.51 / $50.76	Professional	TC	$21.78	$28.51	$50.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.58 / $48.59 / $63.50	Professional		$33.58	$48.59	$63.50
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.40 / $13.32 / $18.17	Professional	26	$9.40	$13.32	$18.17
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.18 / $35.46 / $45.33	Professional	TC	$24.18	$35.46	$45.33