Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $17.38 / $43.65	Facility	26	$6.03	$17.38	$43.65
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $89.13 / $223.87	Facility	TC	$30.20	$89.13	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $34.67 / $93.33	Professional		$13.80	$34.67	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $12.02 / $23.44	Professional	26	$5.01	$12.02	$23.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $107.15 / $186.21	Professional	50	$34.67	$107.15	$186.21
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $19.95 / $19.95 / $26.30	Professional	52	$19.95	$19.95	$26.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $32.36 / $75.86	Professional	TC	$21.88	$32.36	$75.86
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $42.66 / $100.00	Professional		$7.41	$42.66	$100.00
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $7.08 / $7.76	Professional	26	$6.31	$7.08	$7.76
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $33.11 / $39.81	Professional	TC	$18.20	$33.11	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $38.02 / $107.15	Professional		$25.70	$38.02	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $7.59 / $17.78	Professional	26	$5.75	$7.59	$17.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $29.51 / $77.62	Professional	TC	$18.62	$29.51	$77.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $50.12 / $91.20	Professional		$41.69	$50.12	$91.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $7.94 / $14.79	Professional	26	$6.92	$7.94	$14.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $42.66 / $75.86	Professional	TC	$35.48	$42.66	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $43.65 / $114.82	Professional		$23.44	$43.65	$114.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.25 / $8.51 / $19.05	Professional	26	$5.25	$8.51	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $35.48 / $97.72	Professional	TC	$18.20	$35.48	$97.72