Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.45 / $62.45 / $119.95	Facility	26	$13.45	$62.45	$119.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.63 / $39.45 / $95.46	Professional		$36.63	$39.45	$95.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $13.45 / $15.62	Professional	26	$13.00	$13.45	$15.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.63 / $26.00 / $47.07	Professional	TC	$23.63	$26.00	$47.07
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $43.77 / $45.44 / $165.68	Professional		$43.77	$45.44	$165.68
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.67 / $16.30 / $26.89	Professional	26	$14.67	$16.30	$26.89
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.24 / $29.15 / $45.34	Professional	TC	$26.24	$29.15	$45.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.11 / $66.22 / $165.12	Professional		$37.11	$66.22	$165.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.75 / $22.36 / $55.81	Professional	26	$12.75	$22.36	$55.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.36 / $48.20 / $109.31	Professional	TC	$24.36	$48.20	$109.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.07 / $51.03 / $97.04	Professional		$44.07	$51.03	$97.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $17.53 / $33.34	Professional	26	$15.14	$17.53	$33.34
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.93 / $33.50 / $63.70	Professional	TC	$28.93	$33.50	$63.70
United Facility/Professional Professional Modifier Low / Median / High Price $38.28 / $57.42 / $122.96	Professional		$38.28	$57.42	$122.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.67 / $18.89 / $42.24	Professional	26	$12.67	$18.89	$42.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $36.53 / $80.72	Professional	TC	$23.99	$36.53	$80.72