Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $13.49 / $97.22	Facility	26	$13.49	$13.49	$97.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.86 / $59.21 / $100.10	Professional		$54.86	$59.21	$100.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.01 / $13.49 / $16.52	Professional	26	$13.01	$13.49	$16.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.85 / $42.13 / $46.41	Professional	TC	$39.85	$42.13	$46.41
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $62.32 / $70.12 / $113.92	Professional		$62.32	$70.12	$113.92
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $16.38 / $18.20 / $19.84	Professional	26	$16.38	$18.20	$19.84
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $44.12 / $47.58 / $52.02	Professional	TC	$44.12	$47.58	$52.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.58 / $81.19 / $253.30	Professional		$50.58	$81.19	$253.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.79 / $22.33 / $56.02	Professional	26	$12.79	$22.33	$56.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.09 / $58.69 / $197.28	Professional	TC	$38.09	$58.69	$197.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.81 / $147.15 / $147.15	Professional		$66.81	$147.15	$147.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.18 / $33.44 / $33.44	Professional	26	$15.18	$33.44	$33.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $51.64 / $113.71 / $113.71	Professional	TC	$51.64	$113.71	$113.71
United Facility/Professional Professional Modifier Low / Median / High Price $47.41 / $137.97 / $186.45	Professional		$47.41	$137.97	$186.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.71 / $21.52 / $42.37	Professional	26	$12.71	$21.52	$42.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.61 / $53.33 / $144.08	Professional	TC	$33.61	$53.33	$144.08