Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.09 / $16.50 / $24.05	Facility	26	$12.09	$16.50	$24.05
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $42.68 / $70.78 / $283.64	Facility	TC	$42.68	$70.78	$283.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.27 / $52.41 / $215.20	Professional		$44.27	$52.41	$215.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.09 / $15.04 / $33.97	Professional	26	$12.09	$15.04	$33.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.85 / $38.78 / $95.32	Professional	TC	$30.85	$38.78	$95.32
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $53.60 / $57.41 / $72.91	Professional		$53.60	$57.41	$72.91
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.32 / $17.02 / $21.62	Professional	26	$15.32	$17.02	$21.62
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $36.58 / $40.39 / $51.30	Professional	TC	$36.58	$40.39	$51.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.52 / $62.20 / $119.53	Professional		$42.52	$62.20	$119.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.97 / $16.98 / $32.79	Professional	26	$10.97	$16.98	$32.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.42 / $44.25 / $89.32	Professional	TC	$30.42	$44.25	$89.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.83 / $67.30 / $93.64	Professional		$55.83	$67.30	$93.64
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.02 / $16.41 / $23.29	Professional	26	$14.02	$16.41	$23.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $41.63 / $50.30 / $70.34	Professional	TC	$41.63	$50.30	$70.34
United Facility/Professional Professional Modifier Low / Median / High Price $40.72 / $52.96 / $120.00	Professional		$40.72	$52.96	$120.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.38 / $15.16 / $25.65	Professional	26	$11.38	$15.16	$25.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.85 / $37.53 / $70.30	Professional	TC	$28.85	$37.53	$70.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.27 / $61.18 / $79.76	Professional		$42.27	$61.18	$79.76
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.69 / $15.13 / $20.63	Professional	26	$10.69	$15.13	$20.63
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $31.59 / $46.26 / $59.13	Professional	TC	$31.59	$46.26	$59.13