Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.75 / $62.31 / $180.91	Facility	26	$25.75	$62.31	$180.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.35 / $49.45 / $59.53	Professional		$46.35	$49.45	$59.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.87 / $25.75 / $62.31	Professional	26	$24.87	$25.75	$62.31
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $27.65 / $27.65 / $27.65	Professional	52	$27.65	$27.65	$27.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.48 / $23.70 / $27.10	Professional	TC	$21.48	$23.70	$27.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $51.04 / $56.72 / $70.19	Professional		$51.04	$56.72	$70.19
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $30.30 / $33.40 / $36.40	Professional	26	$30.30	$33.40	$36.40
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.32 / $23.32 / $26.57	Professional	TC	$23.32	$23.32	$26.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.31 / $80.37 / $209.06	Professional		$46.31	$80.37	$209.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.10 / $41.30 / $109.75	Professional	26	$24.10	$41.30	$109.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.21 / $35.09 / $99.32	Professional	TC	$22.21	$35.09	$99.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $63.68 / $120.30	Professional		$55.00	$63.68	$120.30
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.62 / $33.14 / $62.22	Professional	26	$28.62	$33.14	$62.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.37 / $30.54 / $58.07	Professional	TC	$26.37	$30.54	$58.07
United Facility/Professional Professional Modifier Low / Median / High Price $45.50 / $66.13 / $180.08	Professional		$45.50	$66.13	$180.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $49.96 / $93.15	Professional	26	$24.78	$49.96	$93.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.09 / $37.02 / $86.93	Professional	TC	$22.09	$37.02	$86.93