Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.73 / $12.73 / $15.40	Facility	26	$12.73	$12.73	$15.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.16 / $75.26 / $302.57	Professional		$55.16	$75.26	$302.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.73 / $17.25 / $48.21	Professional	26	$12.73	$17.25	$48.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.58 / $51.21 / $116.85	Professional	TC	$40.58	$51.21	$116.85
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $63.13 / $70.14 / $89.08	Professional		$63.13	$70.14	$89.08
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $16.44 / $18.27 / $23.20	Professional	26	$16.44	$18.27	$23.20
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $46.69 / $51.88 / $65.89	Professional	TC	$46.69	$51.88	$65.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.26 / $75.77 / $140.94	Professional		$49.26	$75.77	$140.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.55 / $18.64 / $34.60	Professional	26	$11.55	$18.64	$34.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.82 / $58.27 / $104.92	Professional	TC	$37.82	$58.27	$104.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.82 / $80.70 / $108.97	Professional		$63.82	$80.70	$108.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.86 / $19.26 / $31.14	Professional	26	$14.86	$19.26	$31.14
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.89 / $60.79 / $85.14	Professional	TC	$48.89	$60.79	$85.14
United Facility/Professional Professional Modifier Low / Median / High Price $49.22 / $64.80 / $104.47	Professional		$49.22	$64.80	$104.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $17.07 / $34.53	Professional	26	$12.42	$17.07	$34.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.19 / $48.96 / $82.99	Professional	TC	$37.19	$48.96	$82.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.06 / $69.61 / $90.59	Professional		$51.06	$69.61	$90.59
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.94 / $15.83 / $21.59	Professional	26	$11.94	$15.83	$21.59
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $39.11 / $53.97 / $69.00	Professional	TC	$39.11	$53.97	$69.00