Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.00 / $43.56 / $127.36	Facility	26	$18.00	$43.56	$127.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.54 / $96.34 / $233.14	Professional		$78.54	$96.34	$233.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.32 / $18.00 / $43.56	Professional	26	$17.32	$18.00	$43.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.64 / $75.80 / $189.58	Professional	TC	$59.64	$75.80	$189.58
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $92.94 / $110.27 / $137.34	Professional		$92.94	$110.27	$137.34
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.55 / $22.83 / $24.88	Professional	26	$20.55	$22.83	$24.88
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $72.39 / $80.43 / $87.67	Professional	TC	$72.39	$80.43	$87.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.31 / $117.61 / $410.18	Professional		$80.31	$117.61	$410.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.05 / $29.62 / $76.69	Professional	26	$17.05	$29.62	$76.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.02 / $87.60 / $333.48	Professional	TC	$60.02	$87.60	$333.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $106.32 / $234.92 / $234.92	Professional		$106.32	$234.92	$234.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.26 / $43.80 / $43.80	Professional	26	$20.26	$43.80	$43.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $86.06 / $191.11 / $191.11	Professional	TC	$86.06	$191.11	$191.11
United Facility/Professional Professional Modifier Low / Median / High Price $70.34 / $135.56 / $297.67	Professional		$70.34	$135.56	$297.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.97 / $23.38 / $55.51	Professional	26	$15.97	$23.38	$55.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.07 / $107.37 / $242.16	Professional	TC	$46.07	$107.37	$242.16