Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $33.11 / $354.81	Facility	26	$33.11	$33.11	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $79.43 / $199.53	Professional		$61.66	$79.43	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $42.66 / $123.03	Professional	26	$33.11	$42.66	$123.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $36.31 / $63.10	Professional	TC	$19.95	$36.31	$63.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $66.07 / $223.87	Professional		$37.15	$66.07	$223.87
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $40.74 / $58.88	Professional	26	$33.88	$40.74	$58.88
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $21.38 / $54.95	Professional	TC	$19.05	$21.38	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $138.04 / $316.23	Professional		$72.44	$138.04	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $70.79 / $151.36	Professional	26	$38.02	$70.79	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $54.95 / $154.88	Professional	TC	$25.70	$54.95	$154.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $81.28 / $165.96	Professional		$67.61	$81.28	$165.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $38.90 / $79.43	Professional	26	$33.88	$38.90	$79.43
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $41.69 / $87.10	Professional	TC	$34.67	$41.69	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $83.18 / $186.21	Professional		$56.23	$83.18	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $52.48 / $100.00	Professional	26	$33.88	$52.48	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $30.20 / $93.33	Professional	TC	$20.42	$30.20	$93.33