Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.23 / $77.58 / $191.54	Facility	26	$27.23	$77.58	$191.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.33 / $107.06 / $167.28	Professional		$97.33	$107.06	$167.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.23 / $28.91 / $65.89	Professional	26	$27.23	$28.91	$65.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.11 / $76.92 / $120.58	Professional	TC	$70.11	$76.92	$120.58
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $100.55 / $126.54 / $265.36	Professional		$100.55	$126.54	$265.36
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.36 / $35.65 / $38.97	Professional	26	$33.36	$35.65	$38.97
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $66.09 / $90.79 / $103.25	Professional	TC	$66.09	$90.79	$103.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.66 / $123.37 / $322.32	Professional		$80.66	$123.37	$322.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.51 / $37.11 / $94.23	Professional	26	$25.51	$37.11	$94.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.78 / $86.26 / $236.73	Professional	TC	$49.78	$86.26	$236.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.43 / $123.70 / $236.06	Professional		$103.43	$123.70	$236.06
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.41 / $35.07 / $65.88	Professional	26	$30.41	$35.07	$65.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $73.03 / $88.63 / $170.16	Professional	TC	$73.03	$88.63	$170.16
United Facility/Professional Professional Modifier Low / Median / High Price $98.11 / $151.85 / $324.94	Professional		$98.11	$151.85	$324.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.09 / $32.47 / $90.69	Professional	26	$25.09	$32.47	$90.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.18 / $87.11 / $246.58	Professional	TC	$65.18	$87.11	$246.58