Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $11.96 / $11.96 / $11.96	Facility		$11.96	$11.96	$11.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.85 / $43.61 / $109.13	Professional		$24.85	$43.61	$109.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $25.10 / $76.28	Professional	26	$18.48	$25.10	$76.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.35 / $20.23 / $31.91	Professional	TC	$6.35	$20.23	$31.91
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $56.73 / $70.06	Professional		$48.00	$56.73	$70.06
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.94 / $33.94 / $41.93	Professional	26	$33.94	$33.94	$41.93
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $13.17 / $22.79 / $28.15	Professional	TC	$13.17	$22.79	$28.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.70 / $28.75 / $72.98	Professional		$16.70	$28.75	$72.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.34 / $16.55 / $47.77	Professional	26	$0.34	$16.55	$47.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.28 / $12.68 / $28.05	Professional	TC	$0.28	$12.68	$28.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $67.48 / $87.93	Professional		$56.23	$67.48	$87.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.00 / $36.49 / $63.75	Professional	26	$30.00	$36.49	$63.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.23 / $31.48 / $42.59	Professional	TC	$26.23	$31.48	$42.59
United Facility/Professional Professional Modifier Low / Median / High Price $26.65 / $42.27 / $100.04	Professional		$26.65	$42.27	$100.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.09 / $25.98 / $61.61	Professional	26	$19.09	$25.98	$61.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $7.56 / $18.34 / $30.03	Professional	TC	$7.56	$18.34	$30.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.27 / $69.73 / $80.69	Professional		$46.27	$69.73	$80.69
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.08 / $36.49 / $43.74	Professional	26	$27.08	$36.49	$43.74
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.19 / $33.25 / $37.58	Professional	TC	$19.19	$33.25	$37.58