Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.81 / $13.34 / $14.97	Facility	26	$12.81	$13.34	$14.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.33 / $45.00 / $106.18	Professional		$37.33	$45.00	$106.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.49 / $12.36 / $27.64	Professional	26	$10.49	$12.36	$27.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.86 / $32.79 / $57.30	Professional	TC	$26.86	$32.79	$57.30
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $59.04 / $59.04 / $93.43	Professional		$59.04	$59.04	$93.43
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 $43.03 / $43.03 / $68.09	Professional	TC	$43.03	$43.03	$68.09
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 $41.97 / $55.31 / $98.77	Professional		$41.97	$55.31	$98.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.91 / $14.58 / $24.92	Professional	26	$10.91	$14.58	$24.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.38 / $40.47 / $72.70	Professional	TC	$30.38	$40.47	$72.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.13 / $53.17 / $74.59	Professional		$41.13	$53.17	$74.59
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 $30.84 / $39.42 / $53.97	Professional	TC	$30.84	$39.42	$53.97
United Facility/Professional Professional Modifier Low / Median / High Price $36.84 / $48.83 / $83.23	Professional		$36.84	$48.83	$83.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.06 / $13.35 / $23.26	Professional	26	$10.06	$13.35	$23.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.07 / $36.21 / $61.74	Professional	TC	$27.07	$36.21	$61.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.38 / $37.27 / $66.47	Professional		$36.38	$37.27	$66.47
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.18 / $9.66 / $17.17	Professional	26	$9.18	$9.66	$17.17
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $27.19 / $27.61 / $49.28	Professional	TC	$27.19	$27.61	$49.28