Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $13.49 / $15.85	Facility	26	$11.22	$13.49	$15.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $60.26 / $218.78	Professional		$38.02	$60.26	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $23.44 / $56.23	Professional	26	$11.75	$23.44	$56.23
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	52	$144.54	$144.54	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $33.88 / $77.62	Professional	TC	$23.99	$33.88	$77.62
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $45.71 / $56.23	Professional		$15.85	$45.71	$56.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $13.80 / $15.14	Professional	26	$12.30	$13.80	$15.14
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $37.15 / $39.81	Professional	TC	$33.11	$37.15	$39.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.38 / $21.38 / $21.38	Facility	26	$21.38	$21.38	$21.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $45.71 / $91.20	Professional		$32.36	$45.71	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $15.49 / $30.20	Professional	26	$10.23	$15.49	$30.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $32.36 / $74.13	Professional	TC	$20.89	$32.36	$74.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $54.95 / $74.13	Professional		$46.77	$54.95	$74.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $15.14 / $20.42	Professional	26	$13.49	$15.14	$20.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $39.81 / $52.48	Professional	TC	$33.11	$39.81	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $79.43	Professional		$32.36	$44.67	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.13 / $24.55	Professional	26	$10.00	$14.13	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.20 / $54.95	Professional	TC	$21.88	$30.20	$54.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $57.54 / $74.13	Professional		$31.62	$57.54	$74.13
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.49 / $19.95	Professional	26	$8.91	$15.49	$19.95
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $41.69 / $53.70	Professional	TC	$22.91	$41.69	$53.70