Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $26.30 / $81.28	Facility	26	$10.96	$26.30	$81.28
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.84 / $69.18 / $213.80	Facility	TC	$28.84	$69.18	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $40.74 / $91.20	Professional		$32.36	$40.74	$91.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.88 / $45.71	Professional	26	$10.00	$12.88	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $26.92 / $51.29	Professional	TC	$20.89	$26.92	$51.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $43.65 / $144.54	Professional		$30.90	$43.65	$144.54
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $13.49 / $14.79	Professional	26	$12.02	$13.49	$14.79
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $32.36 / $45.71	Professional	TC	$29.51	$32.36	$45.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $46.77 / $123.03	Professional		$33.88	$46.77	$123.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.49 / $33.88	Professional	26	$10.72	$15.49	$33.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.90 / $85.11	Professional	TC	$22.91	$30.90	$85.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $48.98 / $102.33	Professional		$44.67	$48.98	$102.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $13.49 / $28.18	Professional	26	$12.88	$13.49	$28.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $34.67 / $74.13	Professional	TC	$31.62	$34.67	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $128.82	Professional		$32.36	$50.12	$128.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.85 / $35.48	Professional	26	$10.72	$15.85	$35.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $34.67 / $93.33	Professional	TC	$21.88	$34.67	$93.33