Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $9.77 / $9.77	Facility	26	$8.13	$9.77	$9.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $47.86 / $524.81	Professional		$22.91	$47.86	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $54.95	Professional	26	$8.91	$12.02	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $21.88 / $218.78	Professional	TC	$12.88	$21.88	$218.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $25.70 / $38.90	Professional		$8.91	$25.70	$38.90
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.00 / $10.96	Professional	26	$8.32	$10.00	$10.96
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $19.05 / $26.30	Professional	TC	$16.98	$19.05	$26.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $15.14 / $15.14	Facility	26	$15.14	$15.14	$15.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $37.15 / $151.36	Professional		$20.42	$37.15	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $10.96 / $21.38	Professional	26	$7.24	$10.96	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $23.44 / $144.54	Professional	TC	$12.59	$23.44	$144.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $30.20 / $52.48	Professional		$26.30	$30.20	$52.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $10.72 / $14.45	Professional	26	$9.33	$10.72	$14.45
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $19.50 / $31.62	Professional	TC	$16.98	$19.50	$31.62
United Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $33.11 / $104.71	Professional		$20.42	$33.11	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.00 / $17.78	Professional	26	$6.03	$10.00	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $22.91 / $91.20	Professional	TC	$11.75	$22.91	$91.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $30.90 / $38.90	Professional		$22.91	$30.90	$38.90
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $11.22 / $14.13	Professional	26	$8.13	$11.22	$14.13
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $19.95 / $25.70	Professional	TC	$14.79	$19.95	$25.70