Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.37 / $7.70 / $12.67	Facility	26	$6.37	$7.70	$12.67
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $12.89 / $68.84 / $210.14	Facility	TC	$12.89	$68.84	$210.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.77 / $21.61 / $64.81	Professional		$18.77	$21.61	$64.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $7.50 / $34.11	Professional	26	$6.42	$7.50	$34.11
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $45.36 / $45.36 / $45.36	Professional	50	$45.36	$45.36	$45.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.57 / $14.79 / $37.51	Professional	TC	$12.57	$14.79	$37.51
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $23.46 / $26.07 / $29.79	Professional		$23.46	$26.07	$29.79
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.37 / $8.19 / $9.36	Professional	26	$7.37	$8.19	$9.36
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $16.09 / $17.88 / $20.43	Professional	TC	$16.09	$17.88	$20.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.43 / $27.11 / $50.83	Professional		$17.43	$27.11	$50.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.77 / $8.74 / $16.82	Professional	26	$5.77	$8.74	$16.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.65 / $18.66 / $34.65	Professional	TC	$11.65	$18.66	$34.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.53 / $27.04 / $42.68	Professional		$22.53	$27.04	$42.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.43 / $8.58 / $12.93	Professional	26	$7.43	$8.58	$12.93
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $15.07 / $18.23 / $29.75	Professional	TC	$15.07	$18.23	$29.75
United Facility/Professional Professional Modifier Low / Median / High Price $17.89 / $23.82 / $38.79	Professional		$17.89	$23.82	$38.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.76 / $7.94 / $13.70	Professional	26	$5.76	$7.94	$13.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.74 / $15.09 / $27.51	Professional	TC	$11.74	$15.09	$27.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $18.02 / $24.39 / $31.96	Professional		$18.02	$24.39	$31.96
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.97 / $7.92 / $10.80	Professional	26	$5.97	$7.92	$10.80
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $12.06 / $16.57 / $21.18	Professional	TC	$12.06	$16.57	$21.18