Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.17 / $14.17 / $14.17	Facility	26	$14.17	$14.17	$14.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.59 / $45.01 / $81.50	Professional		$37.59	$45.01	$81.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.08 / $14.72 / $30.63	Professional	26	$14.08	$14.72	$30.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $29.29 / $53.95	Professional	TC	$23.51	$29.29	$53.95
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $44.51 / $49.47 / $64.89	Professional		$44.51	$49.47	$64.89
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $16.48 / $18.32 / $20.93	Professional	26	$16.48	$18.32	$20.93
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.19 / $31.15 / $47.88	Professional	TC	$26.19	$31.15	$47.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.97 / $53.81 / $109.69	Professional		$35.97	$53.81	$109.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.82 / $18.57 / $36.04	Professional	26	$12.82	$18.57	$36.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.61 / $35.85 / $74.15	Professional	TC	$22.61	$35.85	$74.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.46 / $56.30 / $81.58	Professional		$45.46	$56.30	$81.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $19.20 / $27.28	Professional	26	$16.39	$19.20	$27.28
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.01 / $37.47 / $54.30	Professional	TC	$28.01	$37.47	$54.30
United Facility/Professional Professional Modifier Low / Median / High Price $36.59 / $47.18 / $81.70	Professional		$36.59	$47.18	$81.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.67 / $16.91 / $30.03	Professional	26	$11.67	$16.91	$30.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.10 / $31.69 / $51.39	Professional	TC	$23.10	$31.69	$51.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.56 / $52.13 / $68.40	Professional		$37.56	$52.13	$68.40
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.98 / $17.63 / $24.05	Professional	26	$12.98	$17.63	$24.05
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.58 / $34.69 / $44.34	Professional	TC	$24.58	$34.69	$44.34