Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.84 / $79.34 / $195.98	Facility	26	$27.84	$79.34	$195.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.87 / $83.32 / $188.44	Professional		$77.87	$83.32	$188.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.84 / $29.23 / $67.37	Professional	26	$27.84	$29.23	$67.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.03 / $52.36 / $121.07	Professional	TC	$50.03	$52.36	$121.07
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $99.25 / $99.25 / $255.73	Professional		$99.25	$99.25	$255.73
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.68 / $34.20 / $64.98	Professional	26	$33.68	$34.20	$64.98
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $58.55 / $65.05 / $107.56	Professional	TC	$58.55	$65.05	$107.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.05 / $110.74 / $257.08	Professional		$72.05	$110.74	$257.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.09 / $37.32 / $96.28	Professional	26	$26.09	$37.32	$96.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.23 / $68.59 / $160.81	Professional	TC	$45.23	$68.59	$160.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.46 / $99.48 / $190.00	Professional		$83.46	$99.48	$190.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.08 / $35.86 / $67.40	Professional	26	$31.08	$35.86	$67.40
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $52.38 / $63.61 / $122.57	Professional	TC	$52.38	$63.61	$122.57
United Facility/Professional Professional Modifier Low / Median / High Price $73.86 / $96.41 / $275.30	Professional		$73.86	$96.41	$275.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.73 / $33.20 / $92.78	Professional	26	$24.73	$33.20	$92.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.90 / $58.35 / $177.63	Professional	TC	$45.90	$58.35	$177.63