Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.88 / $72.70 / $252.97	Facility	26	$28.88	$72.70	$252.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.82 / $67.23 / $114.10	Professional		$51.82	$67.23	$114.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.88 / $31.09 / $43.07	Professional	26	$28.88	$31.09	$43.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $38.36 / $52.42	Professional	TC	$19.32	$38.36	$52.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $69.76 / $77.51 / $193.99	Professional		$69.76	$77.51	$193.99
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $38.83 / $38.83 / $48.54	Professional	26	$38.83	$38.83	$48.54
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.95 / $38.68 / $48.35	Professional	TC	$23.95	$38.68	$48.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.09 / $120.30 / $287.75	Professional		$61.09	$120.30	$287.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.61 / $56.28 / $132.36	Professional	26	$32.61	$56.28	$132.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.14 / $48.97 / $155.38	Professional	TC	$23.14	$48.97	$155.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $62.01 / $73.87 / $156.13	Professional		$62.01	$73.87	$156.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.61 / $32.61 / $67.42	Professional	26	$28.61	$32.61	$67.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.39 / $41.25 / $88.71	Professional	TC	$33.39	$41.25	$88.71
United Facility/Professional Professional Modifier Low / Median / High Price $47.76 / $76.20 / $187.83	Professional		$47.76	$76.20	$187.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.24 / $43.34 / $85.39	Professional	26	$29.24	$43.34	$85.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.10 / $38.20 / $106.72	Professional	TC	$19.10	$38.20	$106.72