Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.12 / $58.97 / $122.13	Facility	26	$13.12	$58.97	$122.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.64 / $45.61 / $61.17	Professional		$42.64	$45.61	$61.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $13.12 / $16.85	Professional	26	$12.80	$13.12	$16.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.84 / $32.49 / $44.32	Professional	TC	$29.84	$32.49	$44.32
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $57.19 / $57.19 / $109.23	Professional		$57.19	$57.19	$109.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.45 / $15.45 / $19.30	Professional	26	$15.45	$15.45	$19.30
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $41.74 / $41.74 / $52.18	Professional	TC	$41.74	$41.74	$52.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.44 / $94.60 / $202.24	Professional		$46.44	$94.60	$202.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $25.15 / $57.55	Professional	26	$14.45	$25.15	$57.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.99 / $62.77 / $137.00	Professional	TC	$31.99	$62.77	$137.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $46.44 / $103.61	Professional		$38.65	$46.44	$103.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.75 / $14.45 / $31.02	Professional	26	$12.75	$14.45	$31.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.90 / $31.99 / $72.56	Professional	TC	$25.90	$31.99	$72.56
United Facility/Professional Professional Modifier Low / Median / High Price $45.55 / $80.56 / $148.00	Professional		$45.55	$80.56	$148.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.31 / $20.20 / $40.38	Professional	26	$12.31	$20.20	$40.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.50 / $50.47 / $93.42	Professional	TC	$33.50	$50.47	$93.42