Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $17.19 / $43.38	Facility	26	$6.03	$17.19	$43.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $74.87 / $210.14 / $243.01	Facility	TC	$74.87	$210.14	$243.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.02 / $36.97 / $59.14	Professional		$25.02	$36.97	$59.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.80 / $6.15 / $14.59	Professional	26	$5.80	$6.15	$14.59
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.96 / $18.48 / $18.48	Professional	52	$16.96	$18.48	$18.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.57 / $30.94 / $74.87	Professional	TC	$25.57	$30.94	$74.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $34.72 / $42.48 / $66.29	Professional		$34.72	$42.48	$66.29
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $6.73 / $7.47 / $8.14	Professional	26	$6.73	$7.47	$8.14
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.07 / $31.50 / $35.04	Professional	TC	$28.07	$31.50	$35.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.71 / $38.24 / $156.32	Professional		$25.71	$38.24	$156.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.71 / $9.31 / $25.73	Professional	26	$5.71	$9.31	$25.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.10 / $31.58 / $130.60	Professional	TC	$19.10	$31.58	$130.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.57 / $91.53 / $91.53	Professional		$41.57	$91.53	$91.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.78 / $14.92 / $14.92	Professional	26	$6.78	$14.92	$14.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $34.79 / $76.61 / $76.61	Professional	TC	$34.79	$76.61	$76.61
United Facility/Professional Professional Modifier Low / Median / High Price $23.28 / $43.30 / $115.98	Professional		$23.28	$43.30	$115.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.24 / $7.66 / $18.91	Professional	26	$5.24	$7.66	$18.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.91 / $41.91 / $97.07	Professional	TC	$19.91	$41.91	$97.07