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 / $12.88	Facility	26	$9.55	$11.48	$12.88
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $107.15 / $457.09	Facility	TC	$23.44	$107.15	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $54.95 / $181.97	Professional		$30.90	$54.95	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $17.78 / $52.48	Professional	26	$10.00	$17.78	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.88 / $97.72	Professional	TC	$20.89	$33.88	$97.72
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $38.02 / $43.65	Professional		$11.75	$38.02	$43.65
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $10.47 / $13.49	Professional	26	$10.47	$10.47	$13.49
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $30.20 / $31.62	Professional	TC	$26.92	$30.20	$31.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $18.20 / $18.20	Facility	26	$18.20	$18.20	$18.20
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $40.74 / $40.74 / $40.74	Facility	TC	$40.74	$40.74	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $38.90 / $74.13	Professional		$27.54	$38.90	$74.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.88 / $25.12	Professional	26	$8.32	$12.88	$25.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.30 / $57.54	Professional	TC	$18.62	$26.30	$57.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $42.66 / $57.54	Professional		$38.02	$42.66	$57.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.30 / $16.60	Professional	26	$10.96	$12.30	$16.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $30.20 / $41.69	Professional	TC	$26.92	$30.20	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $36.31 / $66.07	Professional		$27.54	$36.31	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $20.42	Professional	26	$8.91	$12.02	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $24.55 / $45.71	Professional	TC	$18.62	$24.55	$45.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $44.67 / $60.26	Professional		$28.84	$44.67	$60.26
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $12.88 / $16.98	Professional	26	$8.51	$12.88	$16.98
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $31.62 / $43.65	Professional	TC	$20.89	$31.62	$43.65