Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.48 / $69.76 / $171.80	Facility	26	$24.48	$69.76	$171.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.44 / $67.78 / $95.47	Professional		$53.44	$67.78	$95.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.20 / $24.48 / $58.26	Professional	26	$24.20	$24.48	$58.26
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.72 / $26.72 / $26.72	Professional	52	$26.72	$26.72	$26.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.97 / $48.20 / $63.59	Professional	TC	$28.97	$48.20	$63.59
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $71.86 / $75.78 / $226.57	Professional		$71.86	$75.78	$226.57
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $28.54 / $28.54 / $31.11	Professional	26	$28.54	$28.54	$31.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $43.32 / $47.24 / $62.83	Professional	TC	$43.32	$47.24	$62.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.59 / $104.72 / $234.88	Professional		$51.59	$104.72	$234.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $32.52 / $80.88	Professional	26	$22.91	$32.52	$80.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.68 / $71.12 / $156.13	Professional	TC	$28.68	$71.12	$156.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.48 / $132.47 / $132.47	Professional		$64.48	$132.47	$132.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.63 / $59.09 / $59.09	Professional	26	$28.63	$59.09	$59.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.85 / $73.38 / $73.38	Professional	TC	$35.85	$73.38	$73.38
United Facility/Professional Professional Modifier Low / Median / High Price $70.03 / $113.62 / $191.95	Professional		$70.03	$113.62	$191.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.15 / $39.04 / $81.34	Professional	26	$23.15	$39.04	$81.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.80 / $60.63 / $106.33	Professional	TC	$45.80	$60.63	$106.33