Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.95 / $13.83 / $13.83	Facility	26	$6.95	$13.83	$13.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.16 / $38.11 / $292.43	Facility	TC	$19.16	$38.11	$292.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.17 / $28.29 / $148.00	Professional		$25.17	$28.29	$148.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $7.84 / $20.56	Professional	26	$6.95	$7.84	$20.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.67 / $20.90 / $51.34	Professional	TC	$17.67	$20.90	$51.34
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $29.81 / $31.09 / $39.47	Professional		$29.81	$31.09	$39.47
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $9.51 / $12.08	Professional	26	$8.56	$9.51	$12.08
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.04 / $21.58 / $27.41	Professional	TC	$21.04	$21.58	$27.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.41 / $35.50 / $66.09	Professional		$23.41	$35.50	$66.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.30 / $9.64 / $18.71	Professional	26	$6.30	$9.64	$18.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.73 / $25.00 / $47.71	Professional	TC	$16.73	$25.00	$47.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.66 / $36.96 / $51.64	Professional		$30.66	$36.96	$51.64
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.03 / $9.41 / $13.37	Professional	26	$8.03	$9.41	$13.37
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.55 / $27.29 / $38.27	Professional	TC	$22.55	$27.29	$38.27
United Facility/Professional Professional Modifier Low / Median / High Price $23.06 / $29.59 / $53.94	Professional		$23.06	$29.59	$53.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.53 / $8.66 / $14.86	Professional	26	$6.53	$8.66	$14.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.55 / $20.93 / $39.22	Professional	TC	$16.55	$20.93	$39.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.08 / $33.60 / $43.80	Professional		$24.08	$33.60	$43.80
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.35 / $8.64 / $11.77	Professional	26	$6.35	$8.64	$11.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.73 / $25.05 / $32.03	Professional	TC	$17.73	$25.05	$32.03