Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $27.54 / $27.54	Facility	26	$19.95	$27.54	$27.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.90 / $95.50	Professional		$30.20	$38.90	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $28.18 / $87.10	Professional	26	$19.95	$28.18	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.33 / $12.02 / $23.99	Professional	TC	$9.33	$12.02	$23.99
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $33.88 / $47.86	Professional		$13.18	$33.88	$47.86
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $22.91 / $30.90	Professional	26	$20.89	$22.91	$30.90
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $14.79 / $20.89	Professional	TC	$14.79	$14.79	$20.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.37 / $25.12 / $35.48	Facility	26	$5.37	$25.12	$35.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $40.74 / $69.18	Professional		$31.62	$40.74	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $26.30 / $44.67	Professional	26	$20.42	$26.30	$44.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $14.45 / $24.55	Professional	TC	$11.22	$14.45	$24.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $41.69 / $56.23	Professional		$33.11	$41.69	$56.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $24.55 / $33.88	Professional	26	$19.95	$24.55	$33.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $16.98 / $22.39	Professional	TC	$13.18	$16.98	$22.39
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $38.02 / $64.57	Professional		$27.54	$38.02	$64.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $25.12 / $41.69	Professional	26	$18.62	$25.12	$41.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.33 / $13.18 / $22.39	Professional	TC	$9.33	$13.18	$22.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $44.67 / $56.23	Professional		$29.51	$44.67	$56.23
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $26.92 / $33.11	Professional	26	$18.20	$26.92	$33.11
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $17.78 / $21.88	Professional	TC	$11.22	$17.78	$21.88