Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.07 / $27.51 / $39.95	Facility	26	$20.07	$27.51	$39.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.24 / $48.20 / $189.66	Professional		$39.24	$48.20	$189.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.07 / $24.87 / $105.96	Professional	26	$20.07	$24.87	$105.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.16 / $23.11 / $96.00	Professional	TC	$19.16	$23.11	$96.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $42.98 / $47.75 / $107.55	Professional		$42.98	$47.75	$107.55
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $24.49 / $27.21 / $33.27	Professional	26	$24.49	$27.21	$33.27
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $20.54 / $77.92	Professional	TC	$17.38	$20.54	$77.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.45 / $58.59 / $124.61	Professional		$35.45	$58.59	$124.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.02 / $28.81 / $53.77	Professional	26	$18.02	$28.81	$53.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.80 / $28.46 / $76.55	Professional	TC	$16.80	$28.46	$76.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.24 / $54.74 / $97.40	Professional		$45.24	$54.74	$97.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.55 / $28.26 / $42.92	Professional	26	$23.55	$28.26	$42.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $21.69 / $26.76 / $47.04	Professional	TC	$21.69	$26.76	$47.04
United Facility/Professional Professional Modifier Low / Median / High Price $38.58 / $54.47 / $90.39	Professional		$38.58	$54.47	$90.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.82 / $24.65 / $45.65	Professional	26	$18.82	$24.65	$45.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $28.62 / $57.45	Professional	TC	$19.12	$28.62	$57.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $45.24 / $52.03 / $64.94	Professional		$45.24	$52.03	$64.94
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.55 / $27.08 / $34.39	Professional	26	$23.55	$27.08	$34.39
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $21.69 / $24.94 / $31.07	Professional	TC	$21.69	$24.94	$31.07