Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.62 / $20.62 / $33.38	Facility	26	$20.62	$20.62	$33.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.13 / $58.57 / $232.28	Professional		$45.13	$58.57	$232.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.19 / $30.58 / $73.39	Professional	26	$17.19	$30.58	$73.39
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $54.11 / $54.11 / $54.11	Professional	52	$54.11	$54.11	$54.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.22 / $27.36 / $68.09	Professional	TC	$19.22	$27.36	$68.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $39.28 / $39.28	Professional		$39.28	$39.28	$39.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $25.29 / $25.29	Professional	26	$25.29	$25.29	$25.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.99 / $13.99 / $13.99	Professional	TC	$13.99	$13.99	$13.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.13 / $53.08 / $92.72	Professional		$45.13	$53.08	$92.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.32 / $33.14 / $47.70	Professional	26	$28.32	$33.14	$47.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $16.30 / $19.67 / $45.02	Professional	TC	$16.30	$19.67	$45.02
United Facility/Professional Professional Modifier Low / Median / High Price $42.16 / $55.94 / $93.29	Professional		$42.16	$55.94	$93.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.65 / $31.95 / $52.42	Professional	26	$23.65	$31.95	$52.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $27.67 / $44.87	Professional	TC	$19.64	$27.67	$44.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.10 / $51.90 / $64.89	Professional		$36.10	$51.90	$64.89
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.99 / $33.04 / $41.73	Professional	26	$22.99	$33.04	$41.73
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $13.11 / $18.85 / $23.56	Professional	TC	$13.11	$18.85	$23.56