Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.88 / $52.03 / $114.00	Facility	26	$36.88	$52.03	$114.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.76 / $97.79 / $236.65	Professional		$89.76	$97.79	$236.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.40 / $15.83 / $38.29	Professional	26	$15.40	$15.83	$38.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.34 / $81.95 / $198.31	Professional	TC	$74.34	$81.95	$198.31
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $117.78 / $132.19 / $218.11	Professional		$117.78	$132.19	$218.11
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.02 / $20.02 / $22.27	Professional	26	$20.02	$20.02	$22.27
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $95.45 / $112.17 / $122.27	Professional	TC	$95.45	$112.17	$122.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.22 / $111.56 / $429.38	Professional		$78.22	$111.56	$429.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.30 / $21.53 / $68.94	Professional	26	$15.30	$21.53	$68.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.98 / $88.12 / $360.44	Professional	TC	$63.98	$88.12	$360.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.98 / $235.18 / $235.18	Professional		$104.98	$235.18	$235.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.42 / $39.21 / $39.21	Professional	26	$18.42	$39.21	$39.21
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $86.80 / $195.97 / $195.97	Professional	TC	$86.80	$195.97	$195.97
United Facility/Professional Professional Modifier Low / Median / High Price $93.71 / $140.57 / $298.01	Professional		$93.71	$140.57	$298.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.39 / $25.27 / $49.69	Professional	26	$15.39	$25.27	$49.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.01 / $95.16 / $248.32	Professional	TC	$73.01	$95.16	$248.32