Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $43.65 / $128.82	Facility	26	$18.20	$43.65	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $93.33 / $229.09	Professional		$64.57	$93.33	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $19.95 / $69.18	Professional	26	$15.85	$19.95	$69.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $70.79 / $128.82	Professional	TC	$48.98	$70.79	$128.82
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $102.33 / $154.88	Professional		$19.05	$102.33	$154.88
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $21.38 / $23.44	Professional	26	$19.05	$21.38	$23.44
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $83.18 / $91.20	Professional	TC	$81.28	$83.18	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $97.72 / $281.84	Professional		$74.13	$97.72	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $23.99 / $53.70	Professional	26	$16.98	$23.99	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $77.62 / $218.78	Professional	TC	$56.23	$77.62	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $125.89 / $234.42	Professional		$104.71	$125.89	$234.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $23.44 / $43.65	Professional	26	$20.42	$23.44	$43.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $102.33 / $190.55	Professional	TC	$85.11	$102.33	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $112.20 / $295.12	Professional		$67.61	$112.20	$295.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $24.55 / $54.95	Professional	26	$15.85	$24.55	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $89.13 / $239.88	Professional	TC	$52.48	$89.13	$239.88