Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $67.61 / $169.82	Facility	26	$22.91	$67.61	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $95.50 / $218.78	Professional		$79.43	$95.50	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $30.90 / $89.13	Professional	26	$21.88	$30.90	$89.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $70.79 / $125.89	Professional	TC	$47.86	$70.79	$125.89
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $100.00 / $363.08	Professional		$28.18	$100.00	$363.08
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $26.92 / $28.84	Professional	26	$24.55	$26.92	$28.84
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $75.86 / $91.20	Professional	TC	$56.23	$75.86	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $114.82 / $263.03	Professional		$83.18	$114.82	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $28.84 / $70.79	Professional	26	$22.39	$28.84	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $79.43 / $204.17	Professional	TC	$61.66	$79.43	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $112.20 / $234.42	Professional		$104.71	$112.20	$234.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $28.18 / $57.54	Professional	26	$26.30	$28.18	$57.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $85.11 / $177.83	Professional	TC	$77.62	$85.11	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $302.00	Professional		$81.28	$123.03	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $33.11 / $72.44	Professional	26	$20.89	$33.11	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $83.18 / $223.87	Professional	TC	$60.26	$83.18	$223.87