Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.79 / $7.84 / $11.54	Facility	26	$5.79	$7.84	$11.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $37.45 / $205.73 / $360.78	Facility	TC	$37.45	$205.73	$360.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.88 / $42.84 / $164.47	Professional		$26.88	$42.84	$164.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.83 / $8.89 / $32.00	Professional	26	$5.83	$8.89	$32.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $64.06 / $66.92 / $82.07	Professional	50	$64.06	$66.92	$82.07
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.39 / $18.48 / $38.32	Professional	52	$15.39	$18.48	$38.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $30.94 / $75.33	Professional	TC	$22.57	$30.94	$75.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $34.08 / $38.97 / $49.49	Professional		$34.08	$38.97	$49.49
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $6.73 / $7.47 / $9.49	Professional	26	$6.73	$7.47	$9.49
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.35 / $31.50 / $40.01	Professional	TC	$27.35	$31.50	$40.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.47 / $38.51 / $85.92	Professional		$26.47	$38.51	$85.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.26 / $7.78 / $14.76	Professional	26	$5.26	$7.78	$14.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.29 / $31.15 / $70.75	Professional	TC	$21.29	$31.15	$70.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $46.01 / $66.09	Professional		$37.20	$46.01	$66.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.78 / $7.82 / $11.76	Professional	26	$6.78	$7.82	$11.76
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.91 / $38.45 / $54.91	Professional	TC	$26.91	$38.45	$54.91
United Facility/Professional Professional Modifier Low / Median / High Price $21.08 / $35.71 / $63.82	Professional		$21.08	$35.71	$63.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.19 / $7.22 / $12.43	Professional	26	$5.19	$7.22	$12.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.04 / $28.87 / $56.80	Professional	TC	$18.04	$28.87	$56.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $25.19 / $43.76 / $56.63	Professional		$25.19	$43.76	$56.63
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.28 / $7.19 / $9.81	Professional	26	$4.28	$7.19	$9.81
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $20.90 / $36.61 / $46.82	Professional	TC	$20.90	$36.61	$46.82