Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.45 / $76.41 / $202.51	Facility	26	$21.45	$76.41	$202.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.42 / $35.61 / $78.34	Professional		$33.42	$35.61	$78.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.53 / $21.45 / $51.90	Professional	26	$20.53	$21.45	$51.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.89 / $14.16 / $53.40	Professional	TC	$12.89	$14.16	$53.40
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $45.56 / $45.56 / $290.85	Professional		$45.56	$45.56	$290.85
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $27.15 / $27.15 / $55.28	Professional	26	$27.15	$27.15	$55.28
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $18.41 / $18.41 / $111.64	Professional	TC	$18.41	$18.41	$111.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $130.26 / $191.39	Professional		$41.03	$130.26	$191.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.36 / $41.25 / $105.17	Professional	26	$23.36	$41.25	$105.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.92 / $71.33 / $131.13	Professional	TC	$16.92	$71.33	$131.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.17 / $91.00 / $91.00	Professional		$43.17	$91.00	$91.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.49 / $53.11 / $53.11	Professional	26	$24.49	$53.11	$53.11
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $18.68 / $37.89 / $37.89	Professional	TC	$18.68	$37.89	$37.89
United Facility/Professional Professional Modifier Low / Median / High Price $62.41 / $114.83 / $193.13	Professional		$62.41	$114.83	$193.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.97 / $63.89 / $75.30	Professional	26	$20.97	$63.89	$75.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.75 / $43.03 / $129.91	Professional	TC	$39.75	$43.03	$129.91