Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $30.46 / $90.72	Facility	26	$12.59	$30.46	$90.72
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $91.26 / $111.62 / $283.64	Facility	TC	$91.26	$111.62	$283.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.17 / $51.75 / $125.23	Professional		$47.17	$51.75	$125.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.09 / $13.23 / $30.46	Professional	26	$12.09	$13.23	$30.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.14 / $38.92 / $94.79	Professional	TC	$33.14	$38.92	$94.79
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $53.60 / $61.16 / $113.92	Professional		$53.60	$61.16	$113.92
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.32 / $17.02 / $18.55	Professional	26	$15.32	$17.02	$18.55
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $36.58 / $40.39 / $44.28	Professional	TC	$36.58	$40.39	$44.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.18 / $70.66 / $221.08	Professional		$44.18	$70.66	$221.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.94 / $20.88 / $53.60	Professional	26	$11.94	$20.88	$53.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.42 / $48.88 / $167.48	Professional	TC	$32.42	$48.88	$167.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.12 / $127.98 / $127.98	Professional		$58.12	$127.98	$127.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.17 / $31.20 / $31.20	Professional	26	$14.17	$31.20	$31.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $43.95 / $96.78 / $96.78	Professional	TC	$43.95	$96.78	$96.78
United Facility/Professional Professional Modifier Low / Median / High Price $41.26 / $118.01 / $162.16	Professional		$41.26	$118.01	$162.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.88 / $17.43 / $39.54	Professional	26	$11.88	$17.43	$39.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.85 / $41.58 / $122.63	Professional	TC	$28.85	$41.58	$122.63