Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.29 / $18.05 / $26.44	Facility	26	$13.29	$18.05	$26.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.48 / $48.77 / $254.00	Professional		$43.48	$48.77	$254.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.29 / $16.18 / $52.87	Professional	26	$13.29	$16.18	$52.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.68 / $34.22 / $83.32	Professional	TC	$29.68	$34.22	$83.32
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $46.87 / $52.08 / $66.14	Professional		$46.87	$52.08	$66.14
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.67 / $16.30 / $20.70	Professional	26	$14.67	$16.30	$20.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $32.21 / $35.78 / $45.44	Professional	TC	$32.21	$35.78	$45.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.08 / $54.88 / $101.03	Professional		$40.08	$54.88	$101.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.04 / $18.04 / $34.88	Professional	26	$12.04	$18.04	$34.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.70 / $38.11 / $78.18	Professional	TC	$27.70	$38.11	$78.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.93 / $60.92 / $86.57	Professional		$51.93	$60.92	$86.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.50 / $17.93 / $26.46	Professional	26	$15.50	$17.93	$26.46
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.75 / $43.30 / $61.70	Professional	TC	$35.75	$43.30	$61.70
United Facility/Professional Professional Modifier Low / Median / High Price $37.89 / $53.10 / $96.80	Professional		$37.89	$53.10	$96.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.03 / $16.23 / $37.54	Professional	26	$12.03	$16.23	$37.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.71 / $32.84 / $56.62	Professional	TC	$23.71	$32.84	$56.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.68 / $56.41 / $73.81	Professional		$36.68	$56.41	$73.81
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $16.55 / $22.58	Professional	26	$11.01	$16.55	$22.58
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.67 / $40.09 / $51.24	Professional	TC	$25.67	$40.09	$51.24