Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.93 / $14.92 / $21.75	Facility	26	$10.93	$14.92	$21.75
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.65 / $54.14 / $211.77	Facility	TC	$32.65	$54.14	$211.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.65 / $41.31 / $155.62	Professional		$35.65	$41.31	$155.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.93 / $13.46 / $30.34	Professional	26	$10.93	$13.46	$30.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.32 / $29.90 / $72.47	Professional	TC	$24.32	$29.90	$72.47
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $42.98 / $46.55 / $53.21	Professional		$42.98	$46.55	$53.21
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $13.86 / $15.40 / $17.54	Professional	26	$13.86	$15.40	$17.54
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.04 / $31.15 / $35.61	Professional	TC	$28.04	$31.15	$35.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.60 / $48.16 / $95.09	Professional		$33.60	$48.16	$95.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.89 / $15.34 / $29.72	Professional	26	$9.89	$15.34	$29.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.34 / $33.42 / $67.77	Professional	TC	$23.34	$33.42	$67.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.10 / $52.98 / $74.70	Professional		$44.10	$52.98	$74.70
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.65 / $14.81 / $21.01	Professional	26	$12.65	$14.81	$21.01
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.22 / $37.75 / $53.68	Professional	TC	$31.22	$37.75	$53.68
United Facility/Professional Professional Modifier Low / Median / High Price $32.29 / $42.33 / $76.54	Professional		$32.29	$42.33	$76.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.51 / $13.71 / $23.39	Professional	26	$10.51	$13.71	$23.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.58 / $28.51 / $48.66	Professional	TC	$21.58	$28.51	$48.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $34.09 / $48.16 / $63.00	Professional		$34.09	$48.16	$63.00
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $13.68 / $18.66	Professional	26	$9.86	$13.68	$18.66
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.22 / $34.69 / $44.34	Professional	TC	$24.22	$34.69	$44.34