Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $12.88 / $18.20	Facility	26	$12.88	$12.88	$18.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $56.23 / $218.78	Professional		$33.88	$56.23	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $22.39 / $50.12	Professional	26	$12.88	$22.39	$50.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.20 / $85.11	Professional	TC	$19.95	$30.20	$85.11
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $43.65 / $56.23	Professional		$18.20	$43.65	$56.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $15.85 / $17.78	Professional	26	$14.13	$15.85	$17.78
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $30.20 / $40.74	Professional	TC	$26.92	$30.20	$40.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $24.55 / $24.55	Facility	26	$24.55	$24.55	$24.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $51.29 / $97.72	Professional		$32.36	$51.29	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $17.78 / $34.67	Professional	26	$11.75	$17.78	$34.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $35.48 / $72.44	Professional	TC	$20.89	$35.48	$72.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $72.44	Professional		$44.67	$50.12	$72.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $17.38 / $23.44	Professional	26	$15.49	$17.38	$23.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $33.11 / $48.98	Professional	TC	$28.18	$33.11	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $52.48 / $87.10	Professional		$35.48	$52.48	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $16.22 / $28.18	Professional	26	$12.02	$16.22	$28.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $33.88 / $60.26	Professional	TC	$21.38	$33.88	$60.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $51.29 / $67.61	Professional		$37.15	$51.29	$67.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $18.20 / $22.91	Professional	26	$13.18	$18.20	$22.91
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $33.11 / $44.67	Professional	TC	$23.99	$33.11	$44.67