Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $10.00 / $11.22	Facility	26	$7.94	$10.00	$11.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $66.07 / $186.21	Professional		$51.29	$66.07	$186.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.00 / $33.88	Professional	26	$7.94	$10.00	$33.88
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $39.81 / $39.81 / $39.81	Professional	52	$39.81	$39.81	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $51.29 / $107.15	Professional	TC	$41.69	$51.29	$107.15
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $74.13 / $100.00	Professional		$16.98	$74.13	$100.00
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $10.47 / $13.80	Professional	26	$9.55	$10.47	$13.80
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $63.10 / $79.43	Professional	TC	$56.23	$63.10	$79.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.14 / $10.00 / $14.13	Facility	26	$2.14	$10.00	$14.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $70.79 / $114.82	Professional		$53.70	$70.79	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.47 / $17.38	Professional	26	$8.13	$10.47	$17.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $60.26 / $97.72	Professional	TC	$44.67	$60.26	$97.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $74.13 / $97.72	Professional		$57.54	$74.13	$97.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.23 / $14.45	Professional	26	$8.13	$10.23	$14.45
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $63.10 / $85.11	Professional	TC	$48.98	$63.10	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $66.07 / $112.20	Professional		$47.86	$66.07	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $9.77 / $16.98	Professional	26	$7.24	$9.77	$16.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $54.95 / $95.50	Professional	TC	$40.74	$54.95	$95.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $77.62 / $95.50	Professional		$46.77	$77.62	$95.50
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $11.22 / $13.80	Professional	26	$6.92	$11.22	$13.80
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $66.07 / $83.18	Professional	TC	$39.81	$66.07	$83.18