Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.00 / $13.00 / $17.66	Facility	26	$13.00	$13.00	$17.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.03 / $50.55 / $126.24	Professional		$36.03	$50.55	$126.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $14.46 / $38.46	Professional	26	$13.00	$14.46	$38.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.51 / $32.61 / $98.02	Professional	TC	$22.51	$32.61	$98.02
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $40.90 / $43.77 / $62.75	Professional		$40.90	$43.77	$62.75
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 $26.24 / $27.48 / $45.35	Professional	TC	$26.24	$27.48	$45.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.08 / $53.44 / $96.73	Professional		$33.08	$53.44	$96.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $18.03 / $34.56	Professional	26	$11.77	$18.03	$34.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.14 / $36.01 / $69.25	Professional	TC	$21.14	$36.01	$69.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.86 / $55.29 / $81.05	Professional		$42.86	$55.29	$81.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $17.89 / $27.03	Professional	26	$15.14	$17.89	$27.03
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.62 / $35.63 / $54.31	Professional	TC	$27.62	$35.63	$54.31
United Facility/Professional Professional Modifier Low / Median / High Price $35.21 / $52.81 / $87.90	Professional		$35.21	$52.81	$87.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.80 / $16.23 / $27.39	Professional	26	$11.80	$16.23	$27.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.56 / $32.99 / $58.33	Professional	TC	$21.56	$32.99	$58.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $46.39 / $61.01	Professional		$34.29	$46.39	$61.01
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.19 / $16.19 / $22.08	Professional	26	$12.19	$16.19	$22.08
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.10 / $30.45 / $38.93	Professional	TC	$22.10	$30.45	$38.93