Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.92 / $28.27 / $71.51	Facility	26	$9.92	$28.27	$71.51
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $93.44 / $283.70 / $578.20	Facility	TC	$93.44	$283.70	$578.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.25 / $45.14 / $110.68	Professional		$23.25	$45.14	$110.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $10.42 / $25.37	Professional	26	$9.52	$10.42	$25.37
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $20.76 / $22.57 / $22.57	Professional	52	$20.76	$22.57	$22.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.57 / $35.22 / $85.23	Professional	TC	$31.57	$35.22	$85.23
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $48.73 / $53.30 / $102.28	Professional		$48.73	$53.30	$102.28
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $13.09 / $21.60	Professional	26	$11.78	$13.09	$21.60
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $35.64 / $39.56 / $47.66	Professional	TC	$35.64	$39.56	$47.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.10 / $57.15 / $191.33	Professional		$38.10	$57.15	$191.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.40 / $15.53 / $40.86	Professional	26	$9.40	$15.53	$40.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.89 / $40.61 / $150.46	Professional	TC	$26.89	$40.61	$150.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.08 / $112.49 / $112.49	Professional		$51.08	$112.49	$112.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.17 / $24.60 / $24.60	Professional	26	$11.17	$24.60	$24.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $39.92 / $87.89 / $87.89	Professional	TC	$39.92	$87.89	$87.89
United Facility/Professional Professional Modifier Low / Median / High Price $32.03 / $48.21 / $142.54	Professional		$32.03	$48.21	$142.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.53 / $12.76 / $31.17	Professional	26	$8.53	$12.76	$31.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.54 / $61.52 / $111.37	Professional	TC	$24.54	$61.52	$111.37