Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.37 / $12.37 / $12.37	Facility	26	$12.37	$12.37	$12.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.85 / $54.56 / $250.66	Professional		$45.85	$54.56	$250.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.37 / $14.06 / $33.15	Professional	26	$12.37	$14.06	$33.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.15 / $37.71 / $89.72	Professional	TC	$32.15	$37.71	$89.72
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $55.71 / $61.90 / $78.61	Professional		$55.71	$61.90	$78.61
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.23 / $16.92 / $21.49	Professional	26	$15.23	$16.92	$21.49
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $40.47 / $44.98 / $57.12	Professional	TC	$40.47	$44.98	$57.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.98 / $64.34 / $120.88	Professional		$42.98	$64.34	$120.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.95 / $16.89 / $32.85	Professional	26	$10.95	$16.89	$32.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.15 / $48.33 / $88.49	Professional	TC	$32.15	$48.33	$88.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.82 / $67.23 / $91.69	Professional		$55.82	$67.23	$91.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.99 / $16.37 / $23.82	Professional	26	$13.99	$16.37	$23.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $41.63 / $50.39 / $67.87	Professional	TC	$41.63	$50.39	$67.87
United Facility/Professional Professional Modifier Low / Median / High Price $43.71 / $54.40 / $92.81	Professional		$43.71	$54.40	$92.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.03 / $14.27 / $25.62	Professional	26	$11.03	$14.27	$25.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.35 / $39.85 / $69.33	Professional	TC	$31.35	$39.85	$69.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.92 / $61.13 / $79.73	Professional		$44.92	$61.13	$79.73
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.33 / $15.13 / $20.63	Professional	26	$11.33	$15.13	$20.63
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $33.59 / $46.25 / $59.11	Professional	TC	$33.59	$46.25	$59.11