Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.45 / $47.51 / $93.14	Facility	26	$10.45	$47.51	$93.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.52 / $94.71 / $94.71	Professional		$86.52	$94.71	$94.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.07 / $10.45 / $11.48	Professional	26	$10.07	$10.45	$11.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.44 / $84.26 / $84.26	Professional	TC	$76.44	$84.26	$84.26
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $122.51 / $139.50 / $199.07	Professional		$122.51	$139.50	$199.07
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.98 / $14.15 / $15.31	Professional	26	$12.98	$14.15	$15.31
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $109.53 / $119.39 / $130.93	Professional	TC	$109.53	$119.39	$130.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.78 / $167.19 / $492.97	Professional		$124.78	$167.19	$492.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.92 / $17.00 / $48.71	Professional	26	$9.92	$17.00	$48.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.64 / $151.56 / $444.26	Professional	TC	$111.64	$151.56	$444.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.29 / $126.02 / $247.70	Professional		$104.29	$126.02	$247.70
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $13.64 / $25.94	Professional	26	$11.78	$13.64	$25.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $92.48 / $112.39 / $221.79	Professional	TC	$92.48	$112.39	$221.79
United Facility/Professional Professional Modifier Low / Median / High Price $90.28 / $168.46 / $375.98	Professional		$90.28	$168.46	$375.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.73 / $16.67 / $39.36	Professional	26	$9.73	$16.67	$39.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.97 / $134.32 / $336.61	Professional	TC	$79.97	$134.32	$336.61