Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.50 / $7.45 / $10.96	Facility	26	$5.50	$7.45	$10.96
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.77 / $136.26 / $309.24	Facility	TC	$24.77	$136.26	$309.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.82 / $32.64 / $132.00	Professional		$23.82	$32.64	$132.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.53 / $7.19 / $25.18	Professional	26	$5.53	$7.19	$25.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $25.35 / $97.00	Professional	TC	$19.64	$25.35	$97.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.68 / $34.09 / $43.29	Professional		$30.68	$34.09	$43.29
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $6.36 / $7.07 / $8.98	Professional	26	$6.36	$7.07	$8.98
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $24.32 / $27.02 / $34.32	Professional	TC	$24.32	$27.02	$34.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.15 / $32.54 / $65.18	Professional		$23.15	$32.54	$65.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.99 / $7.50 / $14.43	Professional	26	$4.99	$7.50	$14.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.19 / $25.75 / $51.43	Professional	TC	$18.19	$25.75	$51.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.24 / $35.60 / $51.29	Professional		$30.24	$35.60	$51.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.41 / $7.43 / $11.76	Professional	26	$6.41	$7.43	$11.76
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.79 / $27.58 / $40.72	Professional	TC	$23.79	$27.58	$40.72
United Facility/Professional Professional Modifier Low / Median / High Price $20.87 / $27.24 / $49.15	Professional		$20.87	$27.24	$49.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.82 / $6.86 / $11.29	Professional	26	$4.82	$6.86	$11.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.68 / $21.31 / $37.65	Professional	TC	$14.68	$21.31	$37.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.35 / $32.96 / $42.83	Professional		$22.35	$32.96	$42.83
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.76 / $6.83 / $9.32	Professional	26	$4.76	$6.83	$9.32
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $26.21 / $33.50	Professional	TC	$17.57	$26.21	$33.50