Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.86 / $17.86 / $17.86	Facility	26	$17.86	$17.86	$17.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.73 / $63.02 / $191.40	Professional		$56.73	$63.02	$191.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.86 / $20.09 / $60.83	Professional	26	$17.86	$20.09	$60.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.99 / $43.78 / $130.56	Professional	TC	$37.99	$43.78	$130.56
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $67.67 / $75.22 / $85.98	Professional		$67.67	$75.22	$85.98
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $21.37 / $23.75 / $27.14	Professional	26	$21.37	$23.75	$27.14
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $43.67 / $51.47 / $58.84	Professional	TC	$43.67	$51.47	$58.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.40 / $77.45 / $145.61	Professional		$52.40	$77.45	$145.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.17 / $24.79 / $47.82	Professional	26	$16.17	$24.79	$47.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.11 / $54.53 / $104.79	Professional	TC	$36.11	$54.53	$104.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.73 / $81.29 / $113.27	Professional		$67.73	$81.29	$113.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.65 / $25.13 / $34.31	Professional	26	$20.65	$25.13	$34.31
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $46.80 / $56.16 / $78.95	Professional	TC	$46.80	$56.16	$78.95
United Facility/Professional Professional Modifier Low / Median / High Price $52.28 / $69.47 / $144.41	Professional		$52.28	$69.47	$144.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.74 / $22.74 / $38.85	Professional	26	$15.74	$22.74	$38.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.71 / $43.60 / $71.97	Professional	TC	$34.71	$43.60	$71.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.24 / $73.63 / $96.47	Professional		$52.24	$73.63	$96.47
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $16.14 / $22.32 / $30.44	Professional	26	$16.14	$22.32	$30.44
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $36.09 / $51.66 / $66.03	Professional	TC	$36.09	$51.66	$66.03