Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.95 / $9.41 / $13.83	Facility	26	$6.95	$9.41	$13.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.50 / $35.79 / $132.13	Professional		$17.50	$35.79	$132.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.00 / $9.59 / $38.00	Professional	26	$7.00	$9.59	$38.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.17 / $41.17 / $41.17	Professional	50	$41.17	$41.17	$41.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $23.48 / $57.99	Professional	TC	$18.82	$23.48	$57.99
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $31.00 / $33.61 / $38.42	Professional		$31.00	$33.61	$38.42
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.06 / $8.94 / $10.24	Professional	26	$8.06	$8.94	$10.24
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.51 / $24.66 / $28.18	Professional	TC	$22.51	$24.66	$28.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.52 / $34.02 / $68.51	Professional		$25.52	$34.02	$68.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.30 / $9.41 / $17.71	Professional	26	$6.30	$9.41	$17.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.70 / $25.53 / $55.14	Professional	TC	$18.70	$25.53	$55.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.51 / $40.04 / $56.57	Professional		$31.51	$40.04	$56.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $9.36 / $14.12	Professional	26	$8.11	$9.36	$14.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.24 / $30.80 / $43.20	Professional	TC	$24.24	$30.80	$43.20
United Facility/Professional Professional Modifier Low / Median / High Price $22.37 / $31.76 / $56.00	Professional		$22.37	$31.76	$56.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.94 / $8.66 / $14.86	Professional	26	$5.94	$8.66	$14.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.47 / $23.10 / $41.14	Professional	TC	$16.47	$23.10	$41.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.00 / $37.07 / $48.24	Professional		$22.00	$37.07	$48.24
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.26 / $8.64 / $11.77	Professional	26	$5.26	$8.64	$11.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.73 / $28.52 / $36.46	Professional	TC	$16.73	$28.52	$36.46