Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.64 / $260.72 / $270.50	Facility		$59.64	$260.72	$270.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.76 / $36.76 / $36.76	Facility	26	$36.76	$36.76	$36.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.58 / $59.64 / $103.15	Professional		$51.58	$59.64	$103.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.33 / $36.76 / $47.33	Professional	26	$28.33	$36.76	$47.33
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.79 / $29.82 / $29.82	Professional	52	$25.79	$29.82	$29.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.88 / $29.28 / $56.46	Professional	TC	$22.88	$29.28	$56.46
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $44.91 / $52.63 / $238.55	Professional		$44.91	$52.63	$238.55
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.76 / $27.41 / $32.88	Professional	26	$14.76	$27.41	$32.88
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.62 / $25.22 / $31.02	Professional	TC	$20.62	$25.22	$31.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.45 / $100.10 / $186.21	Professional		$42.45	$100.10	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.64 / $36.97 / $84.62	Professional	26	$23.64	$36.97	$84.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.08 / $61.33 / $121.10	Professional	TC	$15.08	$61.33	$121.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.99 / $108.75 / $108.75	Professional		$51.99	$108.75	$108.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.95 / $66.84 / $66.84	Professional	26	$31.95	$66.84	$66.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $20.04 / $41.91 / $41.91	Professional	TC	$20.04	$41.91	$41.91
United Facility/Professional Professional Modifier Low / Median / High Price $59.39 / $101.19 / $141.09	Professional		$59.39	$101.19	$141.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.82 / $44.58 / $84.04	Professional	26	$24.82	$44.58	$84.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.15 / $44.44 / $85.76	Professional	TC	$27.15	$44.44	$85.76