Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.75 / $73.39 / $180.91	Facility	26	$25.75	$73.39	$180.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.48 / $91.09 / $108.83	Professional		$88.48	$91.09	$108.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.12 / $25.75 / $48.90	Professional	26	$21.12	$25.75	$48.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.61 / $69.95 / $78.97	Professional	TC	$63.61	$69.95	$78.97
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $100.10 / $104.46 / $200.33	Professional		$100.10	$104.46	$200.33
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $24.10 / $28.47 / $43.11	Professional	26	$24.10	$28.47	$43.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $68.39 / $75.98 / $98.85	Professional	TC	$68.39	$75.98	$98.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.50 / $114.15 / $414.85	Professional		$78.50	$114.15	$414.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.34 / $34.29 / $108.33	Professional	26	$22.34	$34.29	$108.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.86 / $78.95 / $306.52	Professional	TC	$53.86	$78.95	$306.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.97 / $119.23 / $229.96	Professional		$102.97	$119.23	$229.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.62 / $33.14 / $62.22	Professional	26	$28.62	$33.14	$62.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $74.34 / $86.09 / $167.74	Professional	TC	$74.34	$86.09	$167.74
United Facility/Professional Professional Modifier Low / Median / High Price $70.83 / $115.77 / $291.39	Professional		$70.83	$115.77	$291.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.92 / $33.79 / $78.84	Professional	26	$17.92	$33.79	$78.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.25 / $156.00 / $212.55	Professional	TC	$54.25	$156.00	$212.55