Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $27.54 / $39.81	Facility	26	$19.95	$27.54	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $79.43 / $263.03	Professional		$38.90	$79.43	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $46.77 / $112.20	Professional	26	$19.95	$46.77	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.12 / $95.50	Professional	TC	$16.98	$25.12	$95.50
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $43.65 / $69.18	Professional		$22.39	$43.65	$69.18
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $24.55 / $31.62	Professional	26	$21.88	$24.55	$31.62
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $23.99 / $27.54	Professional	TC	$21.38	$23.99	$27.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $38.02 / $38.02	Facility	26	$38.02	$38.02	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $58.88 / $125.89	Professional		$35.48	$58.88	$125.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $28.18 / $52.48	Professional	26	$18.20	$28.18	$52.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $28.84 / $81.28	Professional	TC	$16.98	$28.84	$81.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $54.95 / $79.43	Professional		$47.86	$54.95	$79.43
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $28.84 / $40.74	Professional	26	$24.55	$28.84	$40.74
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $26.30 / $38.90	Professional	TC	$22.39	$26.30	$38.90
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $56.23 / $100.00	Professional		$40.74	$56.23	$100.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $25.12 / $45.71	Professional	26	$19.05	$25.12	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $28.18 / $63.10	Professional	TC	$19.50	$28.18	$63.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $58.88 / $69.18	Professional		$45.71	$58.88	$69.18
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $30.20 / $35.48	Professional	26	$23.44	$30.20	$35.48
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.18 / $33.11	Professional	TC	$21.88	$28.18	$33.11