Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $48.98 / $87.10	Facility	26	$10.96	$48.98	$87.10
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $102.33 / $218.78	Facility	TC	$30.20	$102.33	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $41.69 / $107.15	Professional		$36.31	$41.69	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.98 / $57.54	Professional	26	$10.96	$16.98	$57.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.84 / $70.79	Professional	TC	$21.88	$28.84	$70.79
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $50.12 / $199.53	Professional		$18.20	$50.12	$199.53
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $14.13 / $19.05	Professional	26	$12.59	$14.13	$19.05
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $36.31 / $39.81	Professional	TC	$32.36	$36.31	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $57.54 / $114.82	Professional		$39.81	$57.54	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $19.05 / $37.15	Professional	26	$11.48	$19.05	$37.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $38.90 / $77.62	Professional	TC	$25.70	$38.90	$77.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $54.95 / $104.71	Professional		$46.77	$54.95	$104.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $15.49 / $34.67	Professional	26	$13.49	$15.49	$34.67
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $39.81 / $75.86	Professional	TC	$33.11	$39.81	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $58.88 / $134.90	Professional		$38.90	$58.88	$134.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $17.38 / $38.02	Professional	26	$12.88	$17.38	$38.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $36.31 / $95.50	Professional	TC	$25.70	$36.31	$95.50