Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $79.43 / $154.88	Facility	26	$20.89	$79.43	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $64.57 / $165.96	Professional		$28.18	$64.57	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $43.65 / $95.50	Professional	26	$19.95	$43.65	$95.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $30.20 / $102.33	Professional	TC	$10.96	$30.20	$102.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $223.87 / $346.74	Professional		$34.67	$223.87	$346.74
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $28.18 / $51.29	Professional	26	$23.99	$28.18	$51.29
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $21.38 / $114.82	Professional	TC	$18.20	$21.38	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $75.86 / $190.55	Professional		$36.31	$75.86	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $25.70 / $104.71	Professional	26	$20.42	$25.70	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $51.29 / $131.83	Professional	TC	$15.85	$51.29	$131.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $51.29 / $109.65	Professional		$44.67	$51.29	$109.65
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $28.84 / $53.70	Professional	26	$25.12	$28.84	$53.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $21.88 / $61.66	Professional	TC	$19.05	$21.88	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $72.44 / $194.98	Professional		$52.48	$72.44	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $28.84 / $75.86	Professional	26	$20.42	$28.84	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $46.77 / $128.82	Professional	TC	$28.84	$46.77	$128.82