Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $91.20 / $177.83	Facility	26	$38.02	$91.20	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $87.10 / $218.78	Professional		$66.07	$87.10	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $57.54 / $131.83	Professional	26	$38.02	$57.54	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $42.66 / $74.13	Professional	TC	$23.99	$42.66	$74.13
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $91.20 / $302.00	Professional		$64.57	$91.20	$302.00
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $42.66 / $53.70	Professional	26	$38.90	$42.66	$53.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $48.98 / $60.26	Professional	TC	$28.18	$48.98	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $162.18 / $354.81	Professional		$81.28	$162.18	$354.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $75.86 / $173.78	Professional	26	$43.65	$75.86	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $64.57 / $186.21	Professional	TC	$30.90	$64.57	$186.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $93.33 / $194.98	Professional		$79.43	$93.33	$194.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $44.67 / $89.13	Professional	26	$38.90	$44.67	$89.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $50.12 / $104.71	Professional	TC	$40.74	$50.12	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $91.20 / $213.80	Professional		$66.07	$91.20	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $56.23 / $114.82	Professional	26	$37.15	$56.23	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $34.67 / $100.00	Professional	TC	$23.99	$34.67	$100.00