Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $77.62 / $190.55	Facility	26	$26.92	$77.62	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $125.89 / $251.19	Professional		$75.86	$125.89	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $46.77 / $100.00	Professional	26	$25.12	$46.77	$100.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $72.44 / $165.96	Professional	TC	$39.81	$72.44	$165.96
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $102.33 / $354.81	Professional		$66.07	$102.33	$354.81
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $31.62 / $34.67	Professional	26	$28.84	$31.62	$34.67
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $81.28 / $91.20	Professional	TC	$58.88	$81.28	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $288.40	Professional		$81.28	$107.15	$288.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $35.48 / $69.18	Professional	26	$23.99	$35.48	$69.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $69.18 / $204.17	Professional	TC	$46.77	$69.18	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $112.20 / $234.42	Professional		$104.71	$112.20	$234.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $32.36 / $66.07	Professional	26	$30.90	$32.36	$66.07
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $81.28 / $169.82	Professional	TC	$74.13	$81.28	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $114.82 / $302.00	Professional		$93.33	$114.82	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $31.62 / $85.11	Professional	26	$25.70	$31.62	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $85.11 / $208.93	Professional	TC	$67.61	$85.11	$208.93