Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.97 / $47.40 / $122.14	Facility	26	$11.97	$47.40	$122.14
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.94 / $98.49 / $234.41	Facility	TC	$30.94	$98.49	$234.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.61 / $42.91 / $47.25	Professional		$39.61	$42.91	$47.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.51 / $11.97 / $16.04	Professional	26	$11.51	$11.97	$16.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.11 / $30.94 / $31.94	Professional	TC	$28.11	$30.94	$31.94
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $50.53 / $51.23 / $150.90	Professional		$50.53	$51.23	$150.90
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $16.41 / $18.23 / $19.87	Professional	26	$16.41	$18.23	$19.87
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $29.70 / $33.00 / $39.04	Professional	TC	$29.70	$33.00	$39.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.34 / $65.38 / $184.40	Professional		$40.34	$65.38	$184.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.42 / $20.75 / $50.97	Professional	26	$11.42	$20.75	$50.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.99 / $41.01 / $133.43	Professional	TC	$28.99	$41.01	$133.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.91 / $105.50 / $105.50	Professional		$47.91	$105.50	$105.50
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.48 / $29.70 / $29.70	Professional	26	$13.48	$29.70	$29.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $34.43 / $75.80 / $75.80	Professional	TC	$34.43	$75.80	$75.80
United Facility/Professional Professional Modifier Low / Median / High Price $37.63 / $58.59 / $133.68	Professional		$37.63	$58.59	$133.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.82 / $19.43 / $39.78	Professional	26	$12.82	$19.43	$39.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.85 / $32.88 / $96.05	Professional	TC	$25.85	$32.88	$96.05