Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.79 / $70.69 / $291.72	Facility	26	$40.79	$70.69	$291.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.63 / $91.49 / $163.13	Professional		$85.63	$91.49	$163.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.71 / $39.61 / $40.79	Professional	26	$16.71	$39.61	$40.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.01 / $50.69 / $146.43	Professional	TC	$46.01	$50.69	$146.43
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $115.10 / $127.89 / $962.75	Professional		$115.10	$127.89	$962.75
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $19.75 / $54.30 / $59.64	Professional	26	$19.75	$54.30	$59.64
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $65.84 / $73.17 / $120.73	Professional	TC	$65.84	$73.17	$120.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.95 / $249.62 / $593.00	Professional		$84.95	$249.62	$593.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $35.61 / $173.87	Professional	26	$17.78	$35.61	$173.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.57 / $150.91 / $572.54	Professional	TC	$46.57	$150.91	$572.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.88 / $116.81 / $223.72	Professional		$100.88	$116.81	$223.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.57 / $52.77 / $100.33	Professional	26	$45.57	$52.77	$100.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $55.30 / $64.03 / $123.38	Professional	TC	$55.30	$64.03	$123.38
United Facility/Professional Professional Modifier Low / Median / High Price $96.94 / $181.65 / $283.48	Professional		$96.94	$181.65	$283.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.34 / $65.67 / $127.14	Professional	26	$14.34	$65.67	$127.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.53 / $113.39 / $201.98	Professional	TC	$58.53	$113.39	$201.98