Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $56.23 / $165.96	Facility	26	$22.91	$56.23	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $257.04	Professional		$77.62	$104.71	$257.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $26.92 / $74.13	Professional	26	$20.89	$26.92	$74.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $75.86 / $141.25	Professional	TC	$56.23	$75.86	$141.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $109.65 / $389.05	Professional		$85.11	$109.65	$389.05
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $27.54 / $28.84	Professional	26	$24.55	$27.54	$28.84
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $100.00 / $104.71	Professional	TC	$79.43	$100.00	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $112.20 / $257.04	Professional		$85.11	$112.20	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $30.90 / $60.26	Professional	26	$20.42	$30.90	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $79.43 / $199.53	Professional	TC	$64.57	$79.43	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $123.03 / $251.19	Professional		$112.20	$123.03	$251.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $28.18 / $57.54	Professional	26	$26.92	$28.18	$57.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $95.50 / $194.98	Professional	TC	$85.11	$95.50	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $114.82 / $323.59	Professional		$97.72	$114.82	$323.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $28.18 / $74.13	Professional	26	$23.44	$28.18	$74.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $85.11 / $251.19	Professional	TC	$74.13	$85.11	$251.19