Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.53 / $29.38 / $40.85	Facility	26	$20.53	$29.38	$40.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.42 / $70.65 / $226.83	Professional		$33.42	$70.65	$226.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.53 / $25.71 / $71.23	Professional	26	$20.53	$25.71	$71.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.89 / $34.26 / $74.20	Professional	TC	$12.89	$34.26	$74.20
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $45.56 / $45.56 / $87.29	Professional		$45.56	$45.56	$87.29
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $27.15 / $27.15 / $34.47	Professional	26	$27.15	$27.15	$34.47
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $18.41 / $18.41 / $58.29	Professional	TC	$18.41	$18.41	$58.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $66.17 / $147.69	Professional		$32.36	$66.17	$147.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.88 / $29.87 / $64.83	Professional	26	$18.88	$29.87	$64.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.67 / $32.86 / $87.95	Professional	TC	$13.67	$32.86	$87.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.27 / $54.95 / $92.77	Professional		$42.27	$54.95	$92.77
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.41 / $31.49 / $47.11	Professional	26	$24.41	$31.49	$47.11
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $17.86 / $23.22 / $56.00	Professional	TC	$17.86	$23.22	$56.00
United Facility/Professional Professional Modifier Low / Median / High Price $41.65 / $70.25 / $114.83	Professional		$41.65	$70.25	$114.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.09 / $27.00 / $43.06	Professional	26	$19.09	$27.00	$43.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.93 / $36.88 / $53.72	Professional	TC	$20.93	$36.88	$53.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.70 / $48.38 / $59.07	Professional		$41.70	$48.38	$59.07
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $24.08 / $28.07 / $33.51	Professional	26	$24.08	$28.07	$33.51
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.62 / $20.10 / $25.56	Professional	TC	$17.62	$20.10	$25.56