Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $13.18 / $21.88	Facility	26	$10.96	$13.18	$21.88
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.36 / $151.36 / $229.09	Facility	TC	$32.36	$151.36	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $51.29 / $208.93	Professional		$34.67	$51.29	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $20.42 / $47.86	Professional	26	$10.96	$20.42	$47.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.90 / $74.13	Professional	TC	$22.91	$30.90	$74.13
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $42.66 / $48.98	Professional		$30.90	$42.66	$48.98
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $13.49 / $15.14	Professional	26	$12.02	$13.49	$15.14
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $30.90 / $44.67	Professional	TC	$27.54	$30.90	$44.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $20.89 / $20.89	Facility	26	$20.89	$20.89	$20.89
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $46.77 / $46.77 / $46.77	Facility	TC	$46.77	$46.77	$46.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $45.71 / $87.10	Professional		$32.36	$45.71	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.14 / $29.51	Professional	26	$10.00	$15.14	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.90 / $67.61	Professional	TC	$21.88	$30.90	$67.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $48.98 / $67.61	Professional		$44.67	$48.98	$67.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $14.13 / $19.05	Professional	26	$12.59	$14.13	$19.05
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $35.48 / $48.98	Professional	TC	$31.62	$35.48	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $42.66 / $75.86	Professional		$32.36	$42.66	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.80 / $23.44	Professional	26	$10.47	$13.80	$23.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.18 / $53.70	Professional	TC	$21.88	$28.18	$53.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $51.29 / $70.79	Professional		$33.88	$51.29	$70.79
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $14.79 / $19.50	Professional	26	$9.77	$14.79	$19.50
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $37.15 / $51.29	Professional	TC	$23.99	$37.15	$51.29