Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.72 / $3.51 / $5.41	Facility	26	$2.72	$3.51	$5.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.47 / $39.09 / $115.00	Professional		$23.47	$39.09	$115.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.80 / $3.81 / $15.00	Professional	26	$2.80	$3.81	$15.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.03 / $11.94 / $30.28	Professional	52	$11.03	$11.94	$30.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $33.75 / $118.18	Professional	TC	$19.32	$33.75	$118.18
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $22.32 / $24.80 / $92.03	Professional		$22.32	$24.80	$92.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $3.22 / $3.58 / $5.52	Professional	26	$3.22	$3.58	$5.52
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $19.09 / $21.22 / $82.82	Professional	TC	$19.09	$21.22	$82.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.49 / $37.95 / $130.69	Professional		$22.49	$37.95	$130.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.99 / $4.49 / $8.43	Professional	26	$2.99	$4.49	$8.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.62 / $35.43 / $119.37	Professional	TC	$20.62	$35.43	$119.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $23.58 / $30.42 / $53.13	Professional		$23.58	$30.42	$53.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $3.01 / $3.88 / $6.11	Professional	26	$3.01	$3.88	$6.11
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $20.57 / $26.54 / $47.00	Professional	TC	$20.57	$26.54	$47.00
United Facility/Professional Professional Modifier Low / Median / High Price $22.81 / $39.06 / $104.84	Professional		$22.81	$39.06	$104.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.82 / $3.84 / $6.41	Professional	26	$2.82	$3.84	$6.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.29 / $33.79 / $91.03	Professional	TC	$19.29	$33.79	$91.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.58 / $27.12 / $33.68	Professional		$23.58	$27.12	$33.68
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $3.01 / $3.46 / $4.43	Professional	26	$3.01	$3.46	$4.43
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $20.57 / $23.66 / $29.58	Professional	TC	$20.57	$23.66	$29.58