Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $72.44 / $208.93	Facility	26	$28.84	$72.44	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $107.15 / $173.78	Professional		$89.13	$107.15	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $32.36 / $79.43	Professional	26	$26.92	$32.36	$79.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $74.13 / $120.23	Professional	TC	$61.66	$74.13	$120.23
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $109.65 / $588.84	Professional		$77.62	$109.65	$588.84
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $32.36 / $35.48	Professional	26	$31.62	$32.36	$35.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $85.11 / $114.82	Professional	TC	$74.13	$85.11	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $128.82 / $323.59	Professional		$91.20	$128.82	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $39.81 / $89.13	Professional	26	$28.18	$39.81	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $89.13 / $223.87	Professional	TC	$61.66	$89.13	$223.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $120.23 / $257.04	Professional		$112.20	$120.23	$257.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $34.67 / $72.44	Professional	26	$33.11	$34.67	$72.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $87.10 / $186.21	Professional	TC	$79.43	$87.10	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $331.13	Professional		$91.20	$131.83	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $41.69 / $91.20	Professional	26	$27.54	$41.69	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $93.33 / $234.42	Professional	TC	$63.10	$93.33	$234.42