Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $25.12 / $44.67	Professional		$19.95	$25.12	$44.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $19.95 / $25.12	Professional	26	$16.98	$19.95	$25.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $2.00 / $3.98 / $10.00	Professional	TC	$2.00	$3.98	$10.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $37.15 / $57.54	Professional		$19.95	$37.15	$57.54
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $22.39 / $24.55	Professional	26	$22.39	$22.39	$24.55
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $32.36 / $35.48	Professional	TC	$12.30	$32.36	$35.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $33.88 / $112.20	Professional		$19.95	$33.88	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $21.38 / $91.20	Professional	26	$16.60	$21.38	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1.38 / $11.75 / $26.30	Professional	TC	$1.38	$11.75	$26.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $27.54 / $50.12	Professional		$27.54	$27.54	$50.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $22.39 / $41.69	Professional	26	$22.39	$22.39	$41.69
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $5.13 / $5.13 / $8.32	Professional	TC	$5.13	$5.13	$8.32
United Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $36.31 / $72.44	Professional		$17.78	$36.31	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $17.38 / $52.48	Professional	26	$14.45	$17.38	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.95 / $9.77 / $28.84	Professional	TC	$2.95	$9.77	$28.84