Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.76 / $70.56 / $194.32	Facility	26	$62.76	$70.56	$194.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.85 / $66.73 / $113.71	Professional		$63.85	$66.73	$113.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.98 / $26.98 / $47.91	Professional	26	$26.98	$26.98	$47.91
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $31.77 / $31.93 / $31.93	Professional	52	$31.77	$31.93	$31.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.86 / $41.67 / $65.80	Professional	TC	$36.86	$41.67	$65.80
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $89.45 / $89.90 / $231.41	Professional		$89.45	$89.90	$231.41
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $31.28 / $34.71 / $37.83	Professional	26	$31.28	$34.71	$37.83
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $54.74 / $55.19 / $69.64	Professional	TC	$54.74	$55.19	$69.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $102.33 / $210.80	Professional		$58.88	$102.33	$210.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.47 / $37.07 / $90.93	Professional	26	$25.47	$37.07	$90.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.06 / $67.23 / $138.49	Professional	TC	$33.06	$67.23	$138.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.28 / $159.57 / $159.57	Professional		$76.28	$159.57	$159.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.34 / $66.84 / $66.84	Professional	26	$32.34	$66.84	$66.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $43.95 / $92.73 / $92.73	Professional	TC	$43.95	$92.73	$92.73
United Facility/Professional Professional Modifier Low / Median / High Price $58.48 / $81.86 / $219.65	Professional		$58.48	$81.86	$219.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.42 / $31.76 / $92.00	Professional	26	$23.42	$31.76	$92.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.50 / $48.63 / $134.36	Professional	TC	$33.50	$48.63	$134.36