Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.50 / $11.41 / $12.96	Facility	26	$9.50	$11.41	$12.96
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.33 / $105.90 / $390.72	Facility	TC	$23.33	$105.90	$390.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.05 / $35.99 / $144.00	Professional		$31.05	$35.99	$144.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.64 / $12.03 / $47.20	Professional	26	$9.64	$12.03	$47.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.53 / $25.68 / $89.60	Professional	TC	$20.53	$25.68	$89.60
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $36.72 / $39.38 / $45.01	Professional		$36.72	$39.38	$45.01
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.71 / $13.01 / $14.75	Professional	26	$11.71	$13.01	$14.75
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.73 / $26.37 / $30.14	Professional	TC	$23.73	$26.37	$30.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.82 / $42.84 / $82.80	Professional		$28.82	$42.84	$82.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $12.98 / $25.04	Professional	26	$8.59	$12.98	$25.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.01 / $28.71 / $58.11	Professional	TC	$20.01	$28.71	$58.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.24 / $45.96 / $64.58	Professional		$38.24	$45.96	$64.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $12.88 / $18.29	Professional	26	$11.01	$12.88	$18.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.06 / $32.72 / $46.29	Professional	TC	$27.06	$32.72	$46.29
United Facility/Professional Professional Modifier Low / Median / High Price $27.64 / $35.79 / $62.85	Professional		$27.64	$35.79	$62.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $12.26 / $22.23	Professional	26	$9.11	$12.26	$22.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.57 / $24.54 / $42.66	Professional	TC	$18.57	$24.54	$42.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $29.10 / $41.78 / $54.63	Professional		$29.10	$41.78	$54.63
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $11.88 / $16.20	Professional	26	$8.44	$11.88	$16.20
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $20.66 / $30.07 / $38.43	Professional	TC	$20.66	$30.07	$38.43