Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.81 / $7.81 / $7.81	Facility	26	$7.81	$7.81	$7.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.47 / $34.52 / $175.62	Professional		$25.47	$34.52	$175.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.81 / $10.15 / $27.26	Professional	26	$7.81	$10.15	$27.26
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.12 / $13.77 / $51.70	Professional	52	$12.12	$13.77	$51.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.05 / $76.42	Professional	TC	$16.98	$25.05	$76.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $40.31 / $42.17 / $53.56	Professional		$40.31	$42.17	$53.56
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $12.37 / $15.71	Professional	26	$11.14	$12.37	$15.71
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.56 / $29.80 / $37.85	Professional	TC	$28.56	$29.80	$37.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.32 / $39.32 / $75.20	Professional		$23.32	$39.32	$75.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.53 / $22.09	Professional	26	$7.08	$11.53	$22.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.23 / $28.08 / $53.12	Professional	TC	$16.23	$28.08	$53.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.15 / $38.89 / $59.27	Professional		$30.15	$38.89	$59.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.14 / $11.78 / $17.63	Professional	26	$9.14	$11.78	$17.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $27.09 / $41.64	Professional	TC	$21.00	$27.09	$41.64
United Facility/Professional Professional Modifier Low / Median / High Price $26.39 / $35.39 / $65.61	Professional		$26.39	$35.39	$65.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $9.97 / $19.84	Professional	26	$7.58	$9.97	$19.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.50 / $24.18 / $41.16	Professional	TC	$18.50	$24.18	$41.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.12 / $32.74 / $42.81	Professional		$24.12	$32.74	$42.81
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.32 / $9.72 / $13.26	Professional	26	$7.32	$9.72	$13.26
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.80 / $23.13 / $29.55	Professional	TC	$16.80	$23.13	$29.55