Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $91.20 / $275.42	Facility	26	$38.02	$91.20	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $97.72 / $251.19	Professional		$48.98	$97.72	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $47.86 / $169.82	Professional	26	$23.44	$47.86	$169.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $138.04 / $138.04 / $724.44	Professional	50	$138.04	$138.04	$724.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $50.12 / $102.33	Professional	TC	$10.00	$50.12	$102.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $57.54 / $323.59	Professional		$12.30	$57.54	$323.59
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $45.71 / $48.98	Professional	26	$40.74	$45.71	$48.98
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $11.22 / $13.80	Professional	TC	$10.96	$11.22	$13.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $123.03 / $190.55	Professional		$45.71	$123.03	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $36.31 / $95.50	Professional	26	$26.30	$36.31	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.77 / $87.10 / $141.25	Professional	TC	$9.77	$87.10	$141.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $60.26 / $186.21	Professional		$56.23	$60.26	$186.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $46.77 / $95.50	Professional	26	$44.67	$46.77	$95.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $12.88 / $123.03	Professional	TC	$11.75	$12.88	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $102.33 / $177.83	Professional		$74.13	$102.33	$177.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $31.62 / $123.03	Professional	26	$25.70	$31.62	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $46.77 / $91.20	Professional	TC	$37.15	$46.77	$91.20