Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.87 / $29.84 / $33.38	Facility	26	$24.87	$29.84	$33.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.74 / $57.89 / $227.21	Professional		$48.74	$57.89	$227.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.75 / $42.85 / $140.44	Professional	26	$25.75	$42.85	$140.44
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $24.00 / $57.49 / $285.00	Professional	52	$24.00	$57.49	$285.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.48 / $25.58 / $141.00	Professional	TC	$21.48	$25.58	$141.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $56.72 / $56.72 / $72.03	Professional		$56.72	$56.72	$72.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.40 / $33.40 / $42.42	Professional	26	$33.40	$33.40	$42.42
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.32 / $23.32 / $32.54	Professional	TC	$23.32	$23.32	$32.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.29 / $63.03 / $119.02	Professional		$41.29	$63.03	$119.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.23 / $33.61 / $65.70	Professional	26	$22.23	$33.61	$65.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.38 / $29.71 / $55.30	Professional	TC	$19.38	$29.71	$55.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.84 / $63.68 / $92.72	Professional		$53.84	$63.68	$92.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.32 / $33.14 / $47.70	Professional	26	$28.32	$33.14	$47.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.98 / $30.13 / $45.02	Professional	TC	$24.98	$30.13	$45.02
United Facility/Professional Professional Modifier Low / Median / High Price $45.04 / $60.07 / $96.50	Professional		$45.04	$60.07	$96.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.53 / $33.75 / $68.93	Professional	26	$23.53	$33.75	$68.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.21 / $27.67 / $48.21	Professional	TC	$20.21	$27.67	$48.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.07 / $57.89 / $77.22	Professional		$43.07	$57.89	$77.22
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.99 / $30.60 / $41.73	Professional	26	$22.99	$30.60	$41.73
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $20.09 / $27.76 / $35.49	Professional	TC	$20.09	$27.76	$35.49