Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $28.18 / $70.79	Facility	26	$8.91	$28.18	$70.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.67 / $100.00 / $257.04	Facility	TC	$34.67	$100.00	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $47.86 / $141.25	Professional		$22.39	$47.86	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $23.44 / $57.54	Professional	26	$8.91	$23.44	$57.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $123.03 / $269.15	Professional	50	$42.66	$123.03	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $36.31 / $85.11	Professional	TC	$26.92	$36.31	$85.11
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $52.48 / $134.90	Professional		$35.48	$52.48	$134.90
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $11.75 / $27.54	Professional	26	$10.47	$11.75	$27.54
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $38.90 / $48.98	Professional	TC	$37.15	$38.90	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $47.86 / $131.83	Professional		$36.31	$47.86	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.18 / $29.51	Professional	26	$9.33	$13.18	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $35.48 / $89.13	Professional	TC	$25.12	$35.48	$89.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $63.10 / $112.20	Professional		$52.48	$63.10	$112.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $13.18 / $24.55	Professional	26	$11.48	$13.18	$24.55
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $50.12 / $87.10	Professional	TC	$41.69	$50.12	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $52.48 / $141.25	Professional		$32.36	$52.48	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $13.49 / $30.90	Professional	26	$8.51	$13.49	$30.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $39.81 / $112.20	Professional	TC	$23.99	$39.81	$112.20