Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $74.13 / $181.97	Facility	26	$25.12	$74.13	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $95.50 / $162.18	Professional		$70.79	$95.50	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $36.31 / $77.62	Professional	26	$20.89	$36.31	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $69.18 / $141.25	Professional	TC	$52.48	$69.18	$141.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $104.71 / $269.15	Professional		$39.81	$104.71	$269.15
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $26.92 / $33.11	Professional	26	$23.99	$26.92	$33.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $72.44 / $102.33	Professional	TC	$67.61	$72.44	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $104.71 / $239.88	Professional		$75.86	$104.71	$239.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $27.54 / $75.86	Professional	26	$21.38	$27.54	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $77.62 / $177.83	Professional	TC	$52.48	$77.62	$177.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $109.65 / $229.09	Professional		$100.00	$109.65	$229.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $30.20 / $66.07	Professional	26	$28.84	$30.20	$66.07
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $77.62 / $165.96	Professional	TC	$70.79	$77.62	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $114.82 / $288.40	Professional		$70.79	$114.82	$288.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $36.31 / $79.43	Professional	26	$17.78	$36.31	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $81.28 / $213.80	Professional	TC	$52.48	$81.28	$213.80