Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.00 / $13.01 / $17.66	Facility	26	$13.00	$13.01	$17.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.49 / $60.35 / $261.25	Professional		$51.49	$60.35	$261.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.01 / $16.52 / $66.40	Professional	26	$13.01	$16.52	$66.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.11 / $43.83 / $112.90	Professional	TC	$37.11	$43.83	$112.90
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $62.32 / $65.78 / $83.54	Professional		$62.32	$65.78	$83.54
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $16.38 / $18.20 / $23.11	Professional	26	$16.38	$18.20	$23.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $44.12 / $47.58 / $60.43	Professional	TC	$44.12	$47.58	$60.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.79 / $71.70 / $139.55	Professional		$48.79	$71.70	$139.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.80 / $18.17 / $35.13	Professional	26	$11.80	$18.17	$35.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.01 / $52.64 / $104.92	Professional	TC	$36.01	$52.64	$104.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.09 / $77.37 / $107.64	Professional		$64.09	$77.37	$107.64
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.02 / $17.57 / $24.35	Professional	26	$15.02	$17.57	$24.35
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.92 / $59.09 / $83.28	Professional	TC	$48.92	$59.09	$83.28
United Facility/Professional Professional Modifier Low / Median / High Price $47.18 / $61.28 / $135.32	Professional		$47.18	$61.28	$135.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.07 / $15.61 / $27.72	Professional	26	$12.07	$15.61	$27.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.70 / $43.67 / $81.77	Professional	TC	$34.70	$43.67	$81.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $49.10 / $70.34 / $91.57	Professional		$49.10	$70.34	$91.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.62 / $16.19 / $22.08	Professional	26	$11.62	$16.19	$22.08
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $37.47 / $54.36 / $69.48	Professional	TC	$37.47	$54.36	$69.48