Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $45.71 / $100.00	Facility	26	$12.88	$45.71	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $50.12 / $117.49	Professional		$41.69	$50.12	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $23.99 / $54.95	Professional	26	$12.88	$23.99	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $36.31 / $83.18	Professional	TC	$28.84	$36.31	$83.18
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $58.88 / $199.53	Professional		$50.12	$58.88	$199.53
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $16.22 / $17.78	Professional	26	$14.79	$16.22	$17.78
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $39.81 / $46.77	Professional	TC	$36.31	$39.81	$46.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $58.88 / $131.83	Professional		$42.66	$58.88	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $18.20 / $40.74	Professional	26	$13.18	$18.20	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $40.74 / $95.50	Professional	TC	$30.20	$40.74	$95.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $64.57 / $125.89	Professional		$54.95	$64.57	$125.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $18.20 / $33.88	Professional	26	$15.49	$18.20	$33.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $46.77 / $91.20	Professional	TC	$38.90	$46.77	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $61.66 / $158.49	Professional		$42.66	$61.66	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $19.50 / $43.65	Professional	26	$12.02	$19.50	$43.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $43.65 / $114.82	Professional	TC	$30.20	$43.65	$114.82