Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $9.33 / $9.33	Facility	26	$9.33	$9.33	$9.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $57.54 / $208.93	Professional		$33.88	$57.54	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $18.20 / $38.02	Professional	26	$8.91	$18.20	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $40.74 / $112.20	Professional	TC	$25.12	$40.74	$112.20
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $44.67 / $51.29	Professional		$13.18	$44.67	$51.29
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $11.48 / $12.30	Professional	26	$10.23	$11.48	$12.30
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $34.67 / $38.90	Professional	TC	$30.90	$34.67	$38.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $17.38 / $17.38	Facility	26	$17.38	$17.38	$17.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $95.50	Professional		$32.36	$50.12	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.59 / $24.55	Professional	26	$8.32	$12.59	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $38.02 / $72.44	Professional	TC	$24.55	$38.02	$72.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $51.29 / $67.61	Professional		$44.67	$51.29	$67.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.30 / $16.60	Professional	26	$10.96	$12.30	$16.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $38.90 / $50.12	Professional	TC	$33.11	$38.90	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $45.71 / $74.13	Professional		$33.88	$45.71	$74.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.48 / $19.95	Professional	26	$8.51	$11.48	$19.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $34.67 / $57.54	Professional	TC	$25.12	$34.67	$57.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $51.29 / $66.07	Professional		$37.15	$51.29	$66.07
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.88 / $16.22	Professional	26	$9.55	$12.88	$16.22
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $38.90 / $50.12	Professional	TC	$27.54	$38.90	$50.12