Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $85.11 / $181.97	Facility	26	$25.12	$85.11	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $117.49 / $199.53	Professional		$79.43	$117.49	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $25.70 / $75.86	Professional	26	$20.89	$25.70	$75.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $91.20 / $158.49	Professional	TC	$57.54	$91.20	$158.49
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $131.83 / $426.58	Professional		$32.36	$131.83	$426.58
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $29.51 / $34.67	Professional	26	$26.30	$29.51	$34.67
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $100.00 / $123.03	Professional	TC	$77.62	$100.00	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $323.59	Professional		$97.72	$125.89	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $31.62 / $74.13	Professional	26	$23.44	$31.62	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $95.50 / $257.04	Professional	TC	$70.79	$95.50	$257.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $169.82 / $309.03	Professional		$141.25	$169.82	$309.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $34.67 / $63.10	Professional	26	$29.51	$34.67	$63.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $134.90 / $245.47	Professional	TC	$112.20	$134.90	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $151.36 / $389.05	Professional		$79.43	$151.36	$389.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $35.48 / $79.43	Professional	26	$21.38	$35.48	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $114.82 / $309.03	Professional	TC	$58.88	$114.82	$309.03