Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $11.48 / $13.18	Facility	26	$9.55	$11.48	$13.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $38.02 / $288.40 / $794.33	Facility	TC	$38.02	$288.40	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $56.23 / $194.98	Professional		$20.42	$56.23	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $23.44 / $57.54	Professional	26	$10.23	$23.44	$57.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $112.20 / $269.15	Professional	50	$36.31	$112.20	$269.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	52	$43.65	$43.65	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $52.48 / $138.04	Professional	TC	$30.20	$52.48	$138.04
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $60.26	Professional		$32.36	$47.86	$60.26
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $11.75 / $15.85	Professional	26	$10.47	$11.75	$15.85
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $38.02 / $47.86	Professional	TC	$37.15	$38.02	$47.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.78 / $17.78 / $17.78	Facility	26	$17.78	$17.78	$17.78
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $56.23 / $56.23 / $56.23	Facility	TC	$56.23	$56.23	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $46.77 / $97.72	Professional		$34.67	$46.77	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $12.59 / $25.12	Professional	26	$8.51	$12.59	$25.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $34.67 / $81.28	Professional	TC	$25.70	$34.67	$81.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $57.54 / $79.43	Professional		$50.12	$57.54	$79.43
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $12.59 / $17.38	Professional	26	$11.48	$12.59	$17.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $45.71 / $61.66	Professional	TC	$38.02	$45.71	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $44.67 / $77.62	Professional		$31.62	$44.67	$77.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.48 / $19.95	Professional	26	$8.51	$11.48	$19.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $33.11 / $58.88	Professional	TC	$23.44	$33.11	$58.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $60.26 / $77.62	Professional		$31.62	$60.26	$77.62
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $13.18 / $16.98	Professional	26	$7.08	$13.18	$16.98
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $47.86 / $61.66	Professional	TC	$24.55	$47.86	$61.66