Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $70.79 / $208.93	Facility	26	$28.84	$70.79	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $75.86 / $223.87	Professional		$30.20	$75.86	$223.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $45.71 / $131.83	Professional	26	$18.20	$45.71	$131.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $107.15 / $234.42 / $562.34	Professional	50	$107.15	$234.42	$562.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.91 / $28.18 / $173.78	Professional	TC	$8.91	$28.18	$173.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $70.79 / $323.59	Professional		$33.11	$70.79	$323.59
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $34.67 / $38.02	Professional	26	$31.62	$34.67	$38.02
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $36.31 / $39.81	Professional	TC	$32.36	$36.31	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $51.29 / $112.20	Professional		$33.11	$51.29	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $27.54 / $72.44	Professional	26	$20.42	$27.54	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $25.12 / $48.98	Professional	TC	$10.96	$25.12	$48.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $72.44 / $147.91	Professional		$67.61	$72.44	$147.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $34.67 / $72.44	Professional	26	$33.11	$34.67	$72.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $38.02 / $74.13	Professional	TC	$34.67	$38.02	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $56.23 / $190.55	Professional		$26.92	$56.23	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $23.44 / $93.33	Professional	26	$17.78	$23.44	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.77 / $32.36 / $97.72	Professional	TC	$9.77	$32.36	$97.72