Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.70 / $102.52 / $248.52	Facility	26	$28.70	$102.52	$248.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.16 / $71.16 / $124.27	Professional		$71.16	$71.16	$124.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.70 / $28.70 / $50.93	Professional	26	$28.70	$28.70	$50.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.46 / $42.46 / $73.33	Professional	TC	$42.46	$42.46	$73.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $99.95 / $100.37 / $275.33	Professional		$99.95	$100.37	$275.33
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $37.92 / $38.22 / $41.66	Professional	26	$37.92	$38.22	$41.66
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $61.73 / $61.88 / $107.71	Professional	TC	$61.73	$61.88	$107.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.68 / $128.04 / $298.47	Professional		$66.68	$128.04	$298.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.26 / $40.14 / $103.47	Professional	26	$27.26	$40.14	$103.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.17 / $76.59 / $184.51	Professional	TC	$39.17	$76.59	$184.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.35 / $175.95 / $175.95	Professional		$83.35	$175.95	$175.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.39 / $71.12 / $71.12	Professional	26	$34.39	$71.12	$71.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.96 / $104.83 / $104.83	Professional	TC	$48.96	$104.83	$104.83
United Facility/Professional Professional Modifier Low / Median / High Price $79.97 / $143.72 / $242.20	Professional		$79.97	$143.72	$242.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.61 / $49.04 / $103.06	Professional	26	$28.61	$49.04	$103.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.01 / $70.81 / $151.88	Professional	TC	$49.01	$70.81	$151.88