Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.01 / $15.61 / $17.66	Facility	26	$13.01	$15.61	$17.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.83 / $73.29 / $264.00	Professional		$57.83	$73.29	$264.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.23 / $16.09 / $66.40	Professional	26	$13.23	$16.09	$66.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.39 / $54.64 / $132.90	Professional	TC	$42.39	$54.64	$132.90
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $68.75 / $74.68 / $94.84	Professional		$68.75	$74.68	$94.84
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $16.38 / $18.20 / $23.11	Professional	26	$16.38	$18.20	$23.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $50.55 / $56.48 / $71.73	Professional	TC	$50.55	$56.48	$71.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.20 / $78.28 / $153.32	Professional		$54.20	$78.28	$153.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.80 / $18.17 / $35.13	Professional	26	$11.80	$18.17	$35.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.21 / $60.74 / $123.50	Professional	TC	$42.21	$60.74	$123.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.72 / $87.86 / $123.05	Professional		$72.72	$87.86	$123.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.02 / $17.57 / $24.35	Professional	26	$15.02	$17.57	$24.35
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $57.60 / $69.55 / $98.70	Professional	TC	$57.60	$69.55	$98.70
United Facility/Professional Professional Modifier Low / Median / High Price $52.10 / $68.56 / $125.52	Professional		$52.10	$68.56	$125.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.71 / $17.52 / $28.99	Professional	26	$12.71	$17.52	$28.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.61 / $50.78 / $110.68	Professional	TC	$39.61	$50.78	$110.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.10 / $79.98 / $103.89	Professional		$54.10	$79.98	$103.89
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.27 / $16.19 / $22.08	Professional	26	$11.27	$16.19	$22.08
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $42.83 / $64.00 / $81.81	Professional	TC	$42.83	$64.00	$81.81