Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $6.92 / $13.80	Facility	26	$6.92	$6.92	$13.80
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.05 / $38.02 / $295.12	Facility	TC	$19.05	$38.02	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $30.90 / $91.20	Professional		$18.20	$30.90	$91.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.02 / $37.15	Professional	26	$7.08	$12.02	$37.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $21.88 / $51.29	Professional	TC	$15.85	$21.88	$51.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $30.20 / $35.48	Professional		$25.12	$30.20	$35.48
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $8.51 / $9.55	Professional	26	$7.76	$8.51	$9.55
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $22.39 / $26.30	Professional	TC	$21.38	$22.39	$26.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $13.18 / $13.18	Facility	26	$13.18	$13.18	$13.18
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $33.88 / $33.88 / $33.88	Facility	TC	$33.88	$33.88	$33.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $32.36 / $60.26	Professional		$22.91	$32.36	$60.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $9.33 / $18.20	Professional	26	$6.31	$9.33	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $22.91 / $47.86	Professional	TC	$16.22	$22.91	$47.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $34.67 / $46.77	Professional		$30.90	$34.67	$46.77
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $9.12 / $12.59	Professional	26	$8.32	$9.12	$12.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $25.12 / $34.67	Professional	TC	$22.91	$25.12	$34.67
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $29.51 / $53.70	Professional		$22.91	$29.51	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.71 / $14.79	Professional	26	$6.46	$8.71	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $20.89 / $38.90	Professional	TC	$16.60	$20.89	$38.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $36.31 / $47.86	Professional		$23.99	$36.31	$47.86
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $9.55 / $12.30	Professional	26	$6.31	$9.55	$12.30
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $26.30 / $35.48	Professional	TC	$17.78	$26.30	$35.48