Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $14.13 / $14.13	Facility	26	$14.13	$14.13	$14.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $51.29 / $141.25	Professional		$37.15	$51.29	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $19.50 / $54.95	Professional	26	$14.13	$19.50	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.20 / $58.88	Professional	TC	$22.91	$30.20	$58.88
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $46.77 / $58.88	Professional		$30.90	$46.77	$58.88
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $17.38 / $19.05	Professional	26	$15.49	$17.38	$19.05
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $34.67 / $36.31	Professional	TC	$29.51	$34.67	$36.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $26.92 / $26.92	Facility	26	$26.92	$26.92	$26.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $50.12 / $109.65	Professional		$34.67	$50.12	$109.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $17.78 / $36.31	Professional	26	$12.88	$17.78	$36.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $33.88 / $74.13	Professional	TC	$21.38	$33.88	$74.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $54.95 / $75.86	Professional		$47.86	$54.95	$75.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $18.62 / $25.70	Professional	26	$16.98	$18.62	$25.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $36.31 / $48.98	Professional	TC	$30.90	$36.31	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $47.86 / $81.28	Professional		$37.15	$47.86	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $17.78 / $30.20	Professional	26	$12.02	$17.78	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $31.62 / $52.48	Professional	TC	$22.91	$31.62	$52.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $57.54 / $75.86	Professional		$37.15	$57.54	$75.86
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.50 / $25.12	Professional	26	$12.88	$19.50	$25.12
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $38.02 / $51.29	Professional	TC	$24.55	$38.02	$51.29