Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.59 / $59.41 / $206.10	Facility	26	$23.59	$59.41	$206.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.79 / $60.57 / $102.03	Professional		$43.79	$60.57	$102.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.59 / $25.31 / $35.11	Professional	26	$23.59	$25.31	$35.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.87 / $36.97 / $50.85	Professional	TC	$17.87	$36.97	$50.85
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $56.52 / $62.80 / $103.62	Professional		$56.52	$62.80	$103.62
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $25.14 / $25.14 / $31.43	Professional	26	$25.14	$25.14	$31.43
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $37.65 / $37.65 / $47.07	Professional	TC	$37.65	$37.65	$47.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.58 / $111.87 / $254.66	Professional		$52.58	$111.87	$254.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.25 / $45.70 / $106.47	Professional	26	$26.25	$45.70	$106.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.24 / $44.89 / $148.19	Professional	TC	$21.24	$44.89	$148.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.84 / $65.56 / $139.57	Professional		$54.84	$65.56	$139.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.01 / $26.25 / $54.90	Professional	26	$23.01	$26.25	$54.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.83 / $39.32 / $84.66	Professional	TC	$31.83	$39.32	$84.66
United Facility/Professional Professional Modifier Low / Median / High Price $41.45 / $67.70 / $167.90	Professional		$41.45	$67.70	$167.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.25 / $33.49 / $70.77	Professional	26	$21.25	$33.49	$70.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.93 / $36.02 / $101.85	Professional	TC	$16.93	$36.02	$101.85