Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.29 / $89.21 / $276.06	Facility	26	$38.29	$89.21	$276.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.16 / $84.82 / $115.64	Professional		$49.16	$84.82	$115.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.28 / $38.29 / $66.53	Professional	26	$26.28	$38.29	$66.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.87 / $18.29 / $89.34	Professional	TC	$10.87	$18.29	$89.34
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $59.15 / $82.64 / $275.77	Professional		$59.15	$82.64	$275.77
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.00 / $35.35 / $43.44	Professional	26	$33.00	$35.35	$43.44
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $15.71 / $47.29 / $62.90	Professional	TC	$15.71	$47.29	$62.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.18 / $136.08 / $275.16	Professional		$46.18	$136.08	$275.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.04 / $42.64 / $114.00	Professional	26	$27.04	$42.64	$114.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.86 / $90.20 / $178.45	Professional	TC	$9.86	$90.20	$178.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.72 / $121.56 / $121.56	Professional		$57.72	$121.56	$121.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.39 / $94.95 / $94.95	Professional	26	$45.39	$94.95	$94.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $12.33 / $26.61 / $26.61	Professional	TC	$12.33	$26.61	$26.61
United Facility/Professional Professional Modifier Low / Median / High Price $74.12 / $102.22 / $176.13	Professional		$74.12	$102.22	$176.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.58 / $42.42 / $130.69	Professional	26	$25.58	$42.42	$130.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.54 / $56.30 / $89.66	Professional	TC	$38.54	$56.30	$89.66