Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.66 / $80.55 / $169.92	Facility	26	$16.66	$80.55	$169.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.79 / $49.84 / $70.52	Professional		$37.79	$49.84	$70.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.66 / $17.89 / $26.14	Professional	26	$16.66	$17.89	$26.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.44 / $33.18 / $45.65	Professional	TC	$16.44	$33.18	$45.65
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $48.83 / $54.26 / $162.33	Professional		$48.83	$54.26	$162.33
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.36 / $20.36 / $25.45	Professional	26	$20.36	$20.36	$25.45
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $15.83 / $33.90 / $42.38	Professional	TC	$15.83	$33.90	$42.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.10 / $93.83 / $207.18	Professional		$45.10	$93.83	$207.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.43 / $32.46 / $73.38	Professional	26	$18.43	$32.46	$73.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $41.83 / $133.80	Professional	TC	$19.32	$41.83	$133.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.89 / $53.89 / $114.34	Professional		$44.89	$53.89	$114.34
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.18 / $18.43 / $38.54	Professional	26	$16.18	$18.43	$38.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.71 / $35.46 / $75.80	Professional	TC	$28.71	$35.46	$75.80
United Facility/Professional Professional Modifier Low / Median / High Price $35.65 / $54.64 / $137.55	Professional		$35.65	$54.64	$137.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.86 / $25.59 / $49.96	Professional	26	$16.86	$25.59	$49.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.35 / $32.95 / $91.19	Professional	TC	$16.35	$32.95	$91.19