Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.02 / $104.39 / $274.00	Facility	26	$32.02	$104.39	$274.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.76 / $94.83 / $214.48	Professional		$84.76	$94.83	$214.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.02 / $33.97 / $77.48	Professional	26	$32.02	$33.97	$77.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.14 / $56.61 / $136.99	Professional	TC	$54.14	$56.61	$136.99
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $107.04 / $107.04 / $278.14	Professional		$107.04	$107.04	$278.14
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.17 / $40.17 / $96.54	Professional	26	$40.17	$40.17	$96.54
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $66.88 / $66.88 / $130.72	Professional	TC	$66.88	$66.88	$130.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.04 / $120.83 / $295.06	Professional		$82.04	$120.83	$295.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.06 / $42.98 / $112.19	Professional	26	$30.06	$42.98	$112.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.90 / $78.33 / $182.87	Professional	TC	$50.90	$78.33	$182.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $94.78 / $113.00 / $217.30	Professional		$94.78	$113.00	$217.30
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.78 / $78.59 / $78.59	Professional	26	$35.78	$78.59	$78.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $59.00 / $99.00 / $138.71	Professional	TC	$59.00	$99.00	$138.71
United Facility/Professional Professional Modifier Low / Median / High Price $82.24 / $97.44 / $314.85	Professional		$82.24	$97.44	$314.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.48 / $50.53 / $108.20	Professional	26	$29.48	$50.53	$108.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.71 / $86.75 / $190.91	Professional	TC	$53.71	$86.75	$190.91