Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $8.32 / $10.00	Facility	26	$6.92	$8.32	$10.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.90 / $144.54	Professional		$26.92	$38.90	$144.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $12.30 / $23.99	Professional	26	$6.92	$12.30	$23.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.70 / $58.88	Professional	TC	$19.05	$25.70	$58.88
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $32.36 / $38.90	Professional		$8.91	$32.36	$38.90
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $7.94 / $10.00	Professional	26	$7.94	$7.94	$10.00
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $29.51 / $33.11	Professional	TC	$22.39	$29.51	$33.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $13.49 / $13.49	Facility	26	$13.49	$13.49	$13.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $33.88 / $75.86	Professional		$25.12	$33.88	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $9.55 / $18.62	Professional	26	$6.31	$9.55	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.12 / $56.23	Professional	TC	$18.20	$25.12	$56.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $39.81 / $53.70	Professional		$33.88	$39.81	$53.70
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.55 / $13.18	Professional	26	$8.51	$9.55	$13.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $30.20 / $40.74	Professional	TC	$25.70	$30.20	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $32.36 / $57.54	Professional		$23.44	$32.36	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.12 / $15.49	Professional	26	$6.61	$9.12	$15.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $23.44 / $42.66	Professional	TC	$16.98	$23.44	$42.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $41.69 / $53.70	Professional		$22.39	$41.69	$53.70
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.50 / $10.00 / $12.59	Professional	26	$5.50	$10.00	$12.59
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $31.62 / $41.69	Professional	TC	$16.98	$31.62	$41.69