Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.31 / $13.57 / $15.31	Facility	26	$11.31	$13.57	$15.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.27 / $48.53 / $184.83	Professional		$37.27	$48.53	$184.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.31 / $14.03 / $36.33	Professional	26	$11.31	$14.03	$36.33
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $18.64 / $21.67 / $27.61	Professional	52	$18.64	$21.67	$27.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $31.55 / $76.91	Professional	TC	$22.26	$31.55	$76.91
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $42.43 / $48.94 / $55.93	Professional		$42.43	$48.94	$55.93
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.46 / $16.07 / $18.36	Professional	26	$14.46	$16.07	$18.36
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.36 / $32.86 / $37.57	Professional	TC	$26.36	$32.86	$37.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.78 / $47.23 / $100.49	Professional		$33.78	$47.23	$100.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.26 / $15.63 / $30.32	Professional	26	$10.26	$15.63	$30.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.30 / $33.57 / $75.56	Professional	TC	$22.30	$33.57	$75.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.23 / $55.38 / $79.14	Professional		$42.23	$55.38	$79.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.06 / $15.91 / $21.75	Professional	26	$13.06	$15.91	$21.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.82 / $40.38 / $57.39	Professional	TC	$28.82	$40.38	$57.39
United Facility/Professional Professional Modifier Low / Median / High Price $31.58 / $44.62 / $78.79	Professional		$31.58	$44.62	$78.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.24 / $14.92 / $29.38	Professional	26	$10.24	$14.92	$29.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.83 / $30.68 / $54.59	Professional	TC	$21.83	$30.68	$54.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.68 / $51.28 / $66.93	Professional		$31.68	$51.28	$66.93
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.04 / $19.14	Professional	26	$8.91	$14.04	$19.14
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.77 / $37.39 / $47.79	Professional	TC	$22.77	$37.39	$47.79