Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.93 / $25.46 / $27.50	Facility	26	$10.93	$25.46	$27.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.85 / $54.83 / $103.08	Professional		$49.85	$54.83	$103.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $10.93 / $17.80	Professional	26	$10.68	$10.93	$17.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.52 / $27.42 / $27.42	Professional	52	$25.52	$27.42	$27.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.36 / $43.90 / $84.25	Professional	TC	$40.36	$43.90	$84.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $75.65 / $75.65 / $127.98	Professional		$75.65	$75.65	$127.98
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $16.01 / $16.01 / $20.97	Professional	26	$16.01	$16.01	$20.97
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $59.64 / $59.64 / $78.13	Professional	TC	$59.64	$59.64	$78.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.03 / $75.29 / $232.77	Professional		$54.03	$75.29	$232.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.61 / $15.56 / $46.28	Professional	26	$11.61	$15.56	$46.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.90 / $60.47 / $186.49	Professional	TC	$42.90	$60.47	$186.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.17 / $67.61 / $133.08	Professional		$61.17	$67.61	$133.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.79 / $12.97 / $25.84	Professional	26	$11.79	$12.97	$25.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $49.44 / $54.64 / $107.25	Professional	TC	$49.44	$54.64	$107.25
United Facility/Professional Professional Modifier Low / Median / High Price $43.60 / $57.46 / $153.97	Professional		$43.60	$57.46	$153.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.68 / $14.24 / $31.08	Professional	26	$9.68	$14.24	$31.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.50 / $43.46 / $129.02	Professional	TC	$33.50	$43.46	$129.02