Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.68 / $11.68 / $84.22	Facility	26	$11.68	$11.68	$84.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.97 / $28.97 / $206.32	Facility	TC	$28.97	$28.97	$206.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.54 / $38.24 / $40.69	Professional		$37.54	$38.24	$40.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $11.68 / $14.42	Professional	26	$11.23	$11.68	$14.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.05 / $26.32 / $28.97	Professional	TC	$25.05	$26.32	$28.97
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $45.95 / $48.14 / $230.95	Professional		$45.95	$48.14	$230.95
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.24 / $15.82 / $17.23	Professional	26	$14.24	$15.82	$17.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $29.22 / $30.13 / $32.84	Professional	TC	$29.22	$30.13	$32.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.74 / $57.07 / $173.26	Professional		$34.74	$57.07	$173.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.08 / $20.05 / $48.34	Professional	26	$11.08	$20.05	$48.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.52 / $36.47 / $124.92	Professional	TC	$23.52	$36.47	$124.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.02 / $99.93 / $99.93	Professional		$45.02	$99.93	$99.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.16 / $28.97 / $28.97	Professional	26	$13.16	$28.97	$28.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.86 / $70.95 / $70.95	Professional	TC	$31.86	$70.95	$70.95
United Facility/Professional Professional Modifier Low / Median / High Price $32.83 / $59.38 / $126.62	Professional		$32.83	$59.38	$126.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $18.46 / $36.70	Professional	26	$11.09	$18.46	$36.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.34 / $30.97 / $89.92	Professional	TC	$21.34	$30.97	$89.92