Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.29 / $37.00 / $110.28	Facility	26	$15.29	$37.00	$110.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.68 / $70.23 / $76.51	Professional		$65.68	$70.23	$76.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.67 / $15.29 / $16.30	Professional	26	$14.67	$15.29	$16.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.39 / $55.56 / $61.22	Professional	TC	$49.39	$55.56	$61.22
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $74.56 / $88.71 / $130.16	Professional		$74.56	$88.71	$130.16
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $17.73 / $19.71 / $21.48	Professional	26	$17.73	$19.71	$21.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $56.68 / $62.98 / $69.00	Professional	TC	$56.68	$62.98	$69.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.77 / $98.60 / $326.24	Professional		$64.77	$98.60	$326.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.50 / $25.23 / $65.11	Professional	26	$14.50	$25.23	$65.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.72 / $72.63 / $261.12	Professional	TC	$49.72	$72.63	$261.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.44 / $188.74 / $188.74	Professional		$86.44	$188.74	$188.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $17.22 / $37.93 / $37.93	Professional	26	$17.22	$37.93	$37.93
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $69.22 / $150.81 / $150.81	Professional	TC	$69.22	$150.81	$150.81
United Facility/Professional Professional Modifier Low / Median / High Price $56.78 / $114.32 / $239.15	Professional		$56.78	$114.32	$239.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.57 / $24.94 / $48.06	Professional	26	$14.57	$24.94	$48.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.01 / $89.38 / $191.09	Professional	TC	$43.01	$89.38	$191.09