Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $26.92 / $218.78	Facility	26	$26.92	$26.92	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $363.08	Professional		$75.86	$109.65	$363.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $74.13 / $223.87	Professional	26	$25.70	$74.13	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $81.28 / $229.09	Professional	TC	$56.23	$81.28	$229.09
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $100.00 / $131.83	Professional		$28.18	$100.00	$131.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $30.90 / $30.90	Professional	26	$6.92	$30.90	$30.90
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $21.88 / $109.65	Professional	TC	$21.88	$21.88	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $77.62 / $562.34	Professional		$53.70	$77.62	$562.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $18.62 / $128.82	Professional	26	$14.13	$18.62	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $58.88 / $436.52	Professional	TC	$39.81	$58.88	$436.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $316.23	Professional		$169.82	$275.42	$316.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $69.18 / $72.44	Professional	26	$39.81	$69.18	$72.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $208.93 / $245.47	Professional	TC	$128.82	$208.93	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $102.33 / $245.47	Professional		$70.79	$102.33	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $25.70 / $56.23	Professional	26	$18.20	$25.70	$56.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $77.62 / $190.55	Professional	TC	$52.48	$77.62	$190.55