Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $12.88 / $123.03	Facility	26	$12.88	$12.88	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $50.12 / $81.28	Professional		$41.69	$50.12	$81.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.13 / $25.70	Professional	26	$12.02	$14.13	$25.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $34.67 / $54.95	Professional	TC	$28.84	$34.67	$54.95
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $46.77 / $138.04	Professional		$28.84	$46.77	$138.04
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $14.45 / $16.22	Professional	26	$12.88	$14.45	$16.22
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $32.36 / $41.69	Professional	TC	$32.36	$32.36	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $95.50 / $204.17	Professional		$48.98	$95.50	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $26.30 / $57.54	Professional	26	$15.49	$26.30	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $69.18 / $138.04	Professional	TC	$33.88	$69.18	$138.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $45.71 / $109.65	Professional		$38.90	$45.71	$109.65
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $14.45 / $30.90	Professional	26	$12.88	$14.45	$30.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $31.62 / $79.43	Professional	TC	$25.70	$31.62	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $70.79 / $131.83	Professional		$46.77	$70.79	$131.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.95 / $38.90	Professional	26	$12.88	$19.95	$38.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $48.98 / $91.20	Professional	TC	$33.88	$48.98	$91.20