Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.67 / $12.92 / $13.73	Facility	26	$10.67	$12.92	$13.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.05 / $56.61 / $135.94	Professional		$49.05	$56.61	$135.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $13.77 / $48.08	Professional	26	$10.83	$13.77	$48.08
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.04 / $27.42 / $36.45	Professional	52	$23.04	$27.42	$36.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.39 / $43.62 / $76.68	Professional	TC	$36.39	$43.62	$76.68
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $75.65 / $75.65 / $119.71	Professional		$75.65	$75.65	$119.71
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $16.01 / $16.01 / $25.34	Professional	26	$16.01	$16.01	$25.34
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $59.64 / $59.64 / $94.38	Professional	TC	$59.64	$59.64	$94.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $13.55 / $13.55	Facility	26	$13.55	$13.55	$13.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.87 / $70.33 / $123.97	Professional		$52.87	$70.33	$123.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.91 / $14.58 / $25.00	Professional	26	$10.91	$14.58	$25.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.04 / $55.39 / $97.65	Professional	TC	$41.04	$55.39	$97.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.93 / $66.95 / $94.42	Professional		$51.93	$66.95	$94.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.38 / $12.97 / $18.53	Professional	26	$10.38	$12.97	$18.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $41.63 / $53.21 / $74.13	Professional	TC	$41.63	$53.21	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $45.48 / $61.35 / $100.31	Professional		$45.48	$61.35	$100.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $13.39 / $20.39	Professional	26	$9.94	$13.39	$20.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.79 / $48.92 / $80.75	Professional	TC	$35.79	$48.92	$80.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.50 / $46.93 / $83.69	Professional		$46.50	$46.93	$83.69
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.28 / $9.66 / $17.17	Professional	26	$9.28	$9.66	$17.17
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $37.21 / $37.27 / $66.51	Professional	TC	$37.21	$37.27	$66.51