Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $93.33 / $194.98	Facility	26	$25.70	$93.33	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $70.79 / $165.96	Professional		$56.23	$70.79	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.90 / $75.86	Professional	26	$22.91	$30.90	$75.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $66.07 / $213.80 / $257.04	Professional	50	$66.07	$213.80	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $40.74 / $77.62	Professional	TC	$30.20	$40.74	$77.62
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $75.86 / $295.12	Professional		$47.86	$75.86	$295.12
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $31.62 / $35.48	Professional	26	$28.84	$31.62	$35.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $43.65 / $69.18	Professional	TC	$39.81	$43.65	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $89.13 / $190.55	Professional		$57.54	$89.13	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $32.36 / $72.44	Professional	26	$23.99	$32.36	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $53.70 / $107.15	Professional	TC	$30.90	$53.70	$107.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $79.43 / $158.49	Professional		$74.13	$79.43	$158.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $33.11 / $67.61	Professional	26	$31.62	$33.11	$67.61
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $46.77 / $93.33	Professional	TC	$42.66	$46.77	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $72.44 / $204.17	Professional		$58.88	$72.44	$204.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $29.51 / $87.10	Professional	26	$25.12	$29.51	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $43.65 / $128.82	Professional	TC	$32.36	$43.65	$128.82