Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $12.88 / $15.49	Facility	26	$10.72	$12.88	$15.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $74.13 / $218.78	Professional		$44.67	$74.13	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $24.55 / $53.70	Professional	26	$12.02	$24.55	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $57.54 / $104.71	Professional	TC	$33.11	$57.54	$104.71
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $53.70 / $67.61	Professional		$12.02	$53.70	$67.61
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $14.45 / $28.18	Professional	26	$11.48	$14.45	$28.18
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $45.71 / $52.48	Professional	TC	$40.74	$45.71	$52.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $20.89 / $20.89	Facility	26	$20.89	$20.89	$20.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $112.20	Professional		$40.74	$57.54	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $16.22 / $30.90	Professional	26	$9.55	$16.22	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $41.69 / $93.33	Professional	TC	$30.20	$41.69	$93.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $64.57 / $85.11	Professional		$56.23	$64.57	$85.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $14.45 / $19.95	Professional	26	$13.18	$14.45	$19.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $47.86 / $66.07	Professional	TC	$43.65	$47.86	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $51.29 / $89.13	Professional		$40.74	$51.29	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.13 / $25.12	Professional	26	$10.96	$14.13	$25.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $38.02 / $67.61	Professional	TC	$29.51	$38.02	$67.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $85.11	Professional		$41.69	$66.07	$85.11
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $15.14 / $19.05	Professional	26	$9.77	$15.14	$19.05
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $50.12 / $66.07	Professional	TC	$31.62	$50.12	$66.07