Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.95 / $9.93 / $11.15	Facility	26	$7.95	$9.93	$11.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.32 / $58.97 / $136.33	Professional		$51.32	$58.97	$136.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.83 / $9.35 / $34.15	Professional	26	$7.83	$9.35	$34.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.84 / $28.78 / $39.04	Professional	52	$22.84	$28.78	$39.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.84 / $49.36 / $89.08	Professional	TC	$40.84	$49.36	$89.08
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $75.73 / $75.73 / $119.83	Professional		$75.73	$75.73	$119.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $10.68 / $16.91	Professional	26	$10.68	$10.68	$16.91
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $65.05 / $65.05 / $102.94	Professional	TC	$65.05	$65.05	$102.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.06 / $10.06 / $10.06	Facility	26	$10.06	$10.06	$10.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.92 / $72.88 / $126.51	Professional		$52.92	$72.88	$126.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $10.63 / $18.88	Professional	26	$8.11	$10.63	$18.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.14 / $61.48 / $107.52	Professional	TC	$45.14	$61.48	$107.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.37 / $66.19 / $93.39	Professional		$51.37	$66.19	$93.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $9.66 / $13.79	Professional	26	$7.73	$9.66	$13.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $43.79 / $55.98 / $79.34	Professional	TC	$43.79	$55.98	$79.34
United Facility/Professional Professional Modifier Low / Median / High Price $46.54 / $62.81 / $96.31	Professional		$46.54	$62.81	$96.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.07 / $9.52 / $17.34	Professional	26	$7.07	$9.52	$17.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.47 / $53.09 / $81.81	Professional	TC	$39.47	$53.09	$81.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.34 / $46.38 / $82.74	Professional		$46.34	$46.38	$82.74
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.97 / $7.18 / $12.77	Professional	26	$6.97	$7.18	$12.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $39.36 / $39.36 / $69.98	Professional	TC	$39.36	$39.36	$69.98