Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $28.18 / $28.84	Facility	26	$20.42	$28.18	$28.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $79.43 / $245.47	Professional		$34.67	$79.43	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $50.12 / $100.00	Professional	26	$20.89	$50.12	$100.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $38.90 / $102.33	Professional	TC	$12.02	$38.90	$102.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $45.71 / $61.66	Professional		$17.78	$45.71	$61.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $25.70 / $33.11	Professional	26	$23.44	$25.70	$33.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $19.50 / $104.71	Professional	TC	$19.50	$19.50	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $67.61 / $131.83	Professional		$31.62	$67.61	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $29.51 / $63.10	Professional	26	$18.62	$29.51	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $30.20 / $63.10	Professional	TC	$13.18	$30.20	$63.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $50.12 / $93.33	Professional		$41.69	$50.12	$93.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $28.84 / $45.71	Professional	26	$23.99	$28.84	$45.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $21.88 / $56.23	Professional	TC	$17.38	$21.88	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $64.57 / $104.71	Professional		$41.69	$64.57	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $24.55 / $42.66	Professional	26	$19.05	$24.55	$42.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $39.81 / $66.07	Professional	TC	$20.89	$39.81	$66.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $48.98 / $61.66	Professional		$41.69	$48.98	$61.66
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $28.18 / $36.31	Professional	26	$23.99	$28.18	$36.31
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $20.89 / $26.30	Professional	TC	$17.78	$20.89	$26.30