Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $7.76 / $7.76	Facility	26	$7.76	$7.76	$7.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $42.66 / $138.04	Professional		$25.12	$42.66	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.80 / $33.88	Professional	26	$7.94	$13.80	$33.88
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $53.70 / $93.33	Professional	52	$30.20	$53.70	$93.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $26.30 / $87.10	Professional	TC	$15.85	$26.30	$87.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $29.51 / $41.69	Professional		$9.55	$29.51	$41.69
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $8.71 / $12.30	Professional	26	$8.51	$8.71	$12.30
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $22.91 / $30.90	Professional	TC	$20.42	$22.91	$30.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $14.79 / $14.79	Facility	26	$14.79	$14.79	$14.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $38.90 / $75.86	Professional		$23.44	$38.90	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.48 / $21.88	Professional	26	$7.08	$11.48	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $27.54 / $53.70	Professional	TC	$16.22	$27.54	$53.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $37.15 / $48.98	Professional		$32.36	$37.15	$48.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $10.72 / $14.79	Professional	26	$9.55	$10.72	$14.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $26.30 / $33.88	Professional	TC	$22.39	$26.30	$33.88
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $35.48 / $60.26	Professional		$26.30	$35.48	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.00 / $17.78	Professional	26	$7.59	$10.00	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $25.70 / $43.65	Professional	TC	$18.62	$25.70	$43.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $37.15 / $46.77	Professional		$28.18	$37.15	$46.77
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.22 / $14.13	Professional	26	$8.51	$11.22	$14.13
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $26.30 / $33.11	Professional	TC	$19.50	$26.30	$33.11