Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.60 / $71.63 / $211.05	Facility	26	$29.60	$71.63	$211.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.98 / $79.63 / $95.73	Professional		$73.98	$79.63	$95.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.57 / $29.60 / $61.60	Professional	26	$28.57	$29.60	$61.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.41 / $50.03 / $56.38	Professional	TC	$45.41	$50.03	$56.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $97.89 / $97.95 / $422.53	Professional		$97.89	$97.95	$422.53
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $35.40 / $39.34 / $42.88	Professional	26	$35.40	$39.34	$42.88
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $52.75 / $58.61 / $63.88	Professional	TC	$52.75	$58.61	$63.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.76 / $118.36 / $346.08	Professional		$72.76	$118.36	$346.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.07 / $48.90 / $126.10	Professional	26	$28.07	$48.90	$126.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.37 / $65.88 / $219.98	Professional	TC	$43.37	$65.88	$219.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.43 / $100.08 / $192.74	Professional		$86.43	$100.08	$192.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.33 / $38.59 / $72.59	Professional	26	$33.33	$38.59	$72.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $53.11 / $61.49 / $120.15	Professional	TC	$53.11	$61.49	$120.15
United Facility/Professional Professional Modifier Low / Median / High Price $66.25 / $97.95 / $244.23	Professional		$66.25	$97.95	$244.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.28 / $40.00 / $91.98	Professional	26	$27.28	$40.00	$91.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.13 / $70.33 / $152.25	Professional	TC	$37.13	$70.33	$152.25