Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.01 / $36.70 / $92.79	Facility	26	$30.01	$36.70	$92.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.46 / $60.27 / $69.79	Professional		$55.46	$60.27	$69.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.43 / $12.88 / $31.16	Professional	26	$12.43	$12.88	$31.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.03 / $47.40 / $51.73	Professional	TC	$43.03	$47.40	$51.73
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $74.39 / $75.26 / $180.65	Professional		$74.39	$75.26	$180.65
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $17.73 / $19.72 / $32.54	Professional	26	$17.73	$19.72	$32.54
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $49.99 / $55.55 / $91.66	Professional	TC	$49.99	$55.55	$91.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.31 / $82.06 / $256.33	Professional		$56.31	$82.06	$256.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.27 / $22.19 / $53.39	Professional	26	$12.27	$22.19	$53.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.10 / $55.07 / $202.95	Professional	TC	$44.10	$55.07	$202.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.86 / $148.83 / $148.83	Professional		$66.86	$148.83	$148.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $31.91 / $31.91	Professional	26	$14.49	$31.91	$31.91
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $52.37 / $116.94 / $116.94	Professional	TC	$52.37	$116.94	$116.94
United Facility/Professional Professional Modifier Low / Median / High Price $53.12 / $85.28 / $188.59	Professional		$53.12	$85.28	$188.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.69 / $20.32 / $43.11	Professional	26	$13.69	$20.32	$43.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.08 / $64.95 / $148.15	Professional	TC	$39.08	$64.95	$148.15