Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.50 / $6.61 / $7.59	Facility	26	$5.50	$6.61	$7.59
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.55 / $134.90 / $316.23	Facility	TC	$24.55	$134.90	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $38.90 / $131.83	Professional		$13.49	$38.90	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $12.30 / $27.54	Professional	26	$5.89	$12.30	$27.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $32.36 / $75.86	Professional	TC	$19.05	$32.36	$75.86
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $7.08 / $29.51 / $35.48	Professional		$7.08	$29.51	$35.48
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $6.76 / $6.92	Professional	26	$6.03	$6.76	$6.92
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $26.30 / $26.92	Professional	TC	$22.39	$26.30	$26.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $10.47 / $10.47	Facility	26	$10.47	$10.47	$10.47
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.48 / $35.48 / $35.48	Facility	TC	$35.48	$35.48	$35.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $30.90 / $63.10	Professional		$22.91	$30.90	$63.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $7.24 / $14.45	Professional	26	$5.01	$7.24	$14.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $23.99 / $51.29	Professional	TC	$17.78	$23.99	$51.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $34.67 / $46.77	Professional		$30.20	$34.67	$46.77
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $7.24 / $10.00	Professional	26	$6.46	$7.24	$10.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $26.92 / $37.15	Professional	TC	$23.99	$26.92	$37.15
United Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $28.84 / $50.12	Professional		$20.89	$28.84	$50.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.90 / $6.92 / $11.75	Professional	26	$4.90	$6.92	$11.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $21.88 / $38.90	Professional	TC	$16.22	$21.88	$38.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $35.48 / $47.86	Professional		$22.39	$35.48	$47.86
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.79 / $7.59 / $9.77	Professional	26	$4.79	$7.59	$9.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $27.54 / $38.02	Professional	TC	$17.38	$27.54	$38.02