Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.78 / $17.78 / $17.78	Facility	26	$17.78	$17.78	$17.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $72.44 / $194.98	Professional		$52.48	$72.44	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $26.30 / $87.10	Professional	26	$16.98	$26.30	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $48.98 / $109.65	Professional	TC	$34.67	$48.98	$109.65
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $60.26 / $75.86	Professional		$19.95	$60.26	$75.86
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $22.91 / $28.18	Professional	26	$18.62	$22.91	$28.18
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $51.29 / $58.88	Professional	TC	$43.65	$51.29	$58.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $33.88 / $33.88	Facility	26	$33.88	$33.88	$33.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $74.13 / $144.54	Professional		$52.48	$74.13	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $23.99 / $45.71	Professional	26	$16.22	$23.99	$45.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $51.29 / $104.71	Professional	TC	$35.48	$51.29	$104.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $75.86 / $102.33	Professional		$69.18	$75.86	$102.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $23.99 / $32.36	Professional	26	$21.38	$23.99	$32.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $52.48 / $72.44	Professional	TC	$46.77	$52.48	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $66.07 / $117.49	Professional		$51.29	$66.07	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $22.91 / $38.90	Professional	26	$16.22	$22.91	$38.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $43.65 / $77.62	Professional	TC	$34.67	$43.65	$77.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $79.43 / $104.71	Professional		$52.48	$79.43	$104.71
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $24.55 / $31.62	Professional	26	$16.22	$24.55	$31.62
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $54.95 / $74.13	Professional	TC	$36.31	$54.95	$74.13