Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.29 / $38.47 / $56.29	Facility	26	$28.29	$38.47	$56.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.28 / $66.92 / $201.46	Professional		$28.28	$66.92	$201.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.80 / $39.07 / $129.00	Professional	26	$17.80	$39.07	$129.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.77 / $69.90 / $201.46	Professional	50	$69.77	$69.90	$201.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.84 / $11.47 / $81.20	Professional	TC	$8.84	$11.47	$81.20
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $53.41 / $63.14 / $85.18	Professional		$53.41	$63.14	$85.18
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $23.37 / $25.97 / $36.22	Professional	26	$23.37	$25.97	$36.22
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.92 / $37.17 / $42.06	Professional	TC	$23.92	$37.17	$42.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.84 / $52.20 / $113.45	Professional		$30.84	$52.20	$113.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.80 / $27.79 / $64.90	Professional	26	$18.80	$27.79	$64.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.09 / $25.09 / $67.84	Professional	TC	$10.09	$25.09	$67.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.66 / $79.66 / $99.57	Professional		$60.66	$79.66	$99.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.52 / $39.82 / $49.77	Professional	26	$31.52	$39.82	$49.77
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.13 / $40.28 / $59.85	Professional	TC	$31.13	$40.28	$59.85
United Facility/Professional Professional Modifier Low / Median / High Price $25.41 / $54.37 / $106.05	Professional		$25.41	$54.37	$106.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.23 / $24.90 / $57.08	Professional	26	$16.23	$24.90	$57.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.15 / $29.14 / $57.30	Professional	TC	$9.15	$29.14	$57.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.29 / $76.34 / $94.91	Professional		$28.29	$76.34	$94.91
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.14 / $38.15 / $48.09	Professional	26	$14.14	$38.15	$48.09
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.15 / $38.18 / $47.61	Professional	TC	$14.15	$38.18	$47.61