Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.34 / $46.99 / $100.75	Facility	26	$11.34	$46.99	$100.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.91 / $98.08 / $248.16	Professional		$83.91	$98.08	$248.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.21 / $11.34 / $17.70	Professional	26	$11.21	$11.34	$17.70
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $38.93 / $41.96 / $197.84	Professional	52	$38.93	$41.96	$197.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.58 / $72.58 / $121.17	Professional	TC	$72.58	$72.58	$121.17
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $105.93 / $105.93 / $329.56	Professional		$105.93	$105.93	$329.56
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.23 / $12.23 / $13.33	Professional	26	$12.23	$12.23	$13.33
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $93.71 / $93.71 / $108.97	Professional	TC	$93.71	$93.71	$108.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.32 / $123.87 / $255.20	Professional		$82.32	$123.87	$255.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.34 / $14.86 / $34.34	Professional	26	$11.34	$14.86	$34.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.48 / $107.87 / $220.86	Professional	TC	$71.48	$107.87	$220.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.33 / $102.66 / $196.85	Professional		$85.33	$102.66	$196.85
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.96 / $13.62 / $25.90	Professional	26	$11.96	$13.62	$25.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $73.38 / $89.05 / $170.95	Professional	TC	$73.38	$89.05	$170.95
United Facility/Professional Professional Modifier Low / Median / High Price $75.62 / $113.93 / $249.28	Professional		$75.62	$113.93	$249.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.96 / $15.25 / $32.79	Professional	26	$9.96	$15.25	$32.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.93 / $160.19 / $213.10	Professional	TC	$71.93	$160.19	$213.10