Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $33.88 / $38.90	Facility	26	$28.18	$33.88	$38.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $75.86 / $223.87	Professional		$31.62	$75.86	$223.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $48.98 / $128.82	Professional	26	$20.42	$48.98	$128.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.48 / $69.18 / $234.42	Professional	50	$35.48	$69.18	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.91 / $32.36 / $91.20	Professional	TC	$8.91	$32.36	$91.20
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $64.57 / $70.79	Professional		$33.11	$64.57	$70.79
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $34.67 / $34.67	Professional	26	$30.90	$34.67	$34.67
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $36.31 / $39.81	Professional	TC	$32.36	$36.31	$39.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $53.70 / $53.70	Facility	26	$53.70	$53.70	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $107.15	Professional		$30.20	$50.12	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $26.30 / $57.54	Professional	26	$17.78	$26.30	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $22.91 / $57.54	Professional	TC	$10.00	$22.91	$57.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $97.72	Professional		$57.54	$75.86	$97.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.02 / $47.86	Professional	26	$28.18	$38.02	$47.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $38.90 / $51.29	Professional	TC	$25.70	$38.90	$51.29
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $50.12 / $97.72	Professional		$26.30	$50.12	$97.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $24.55 / $45.71	Professional	26	$16.22	$24.55	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.12 / $28.18 / $57.54	Professional	TC	$9.12	$28.18	$57.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $83.18 / $97.72	Professional		$28.18	$83.18	$97.72
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $39.81 / $48.98	Professional	26	$14.13	$39.81	$48.98
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $43.65 / $48.98	Professional	TC	$14.13	$43.65	$48.98