Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.14 / $18.96 / $20.47	Facility	26	$8.14	$18.96	$20.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.67 / $57.56 / $108.21	Professional		$52.67	$57.56	$108.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $8.14 / $13.16	Professional	26	$7.45	$8.14	$13.16
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.66 / $28.78 / $28.78	Professional	52	$26.66	$28.78	$28.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.29 / $49.42 / $89.08	Professional	TC	$45.29	$49.42	$89.08
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $75.73 / $75.73 / $318.45	Professional		$75.73	$75.73	$318.45
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $10.68 / $13.99	Professional	26	$10.68	$10.68	$13.99
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $65.05 / $65.05 / $85.22	Professional	TC	$65.05	$65.05	$85.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.75 / $76.56 / $231.41	Professional		$54.75	$76.56	$231.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.64 / $11.16 / $34.03	Professional	26	$8.64	$11.16	$34.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.12 / $65.78 / $197.38	Professional	TC	$46.12	$65.78	$197.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.73 / $67.13 / $135.34	Professional		$60.73	$67.13	$135.34
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $9.65 / $19.21	Professional	26	$8.77	$9.65	$19.21
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $52.00 / $57.48 / $116.13	Professional	TC	$52.00	$57.48	$116.13
United Facility/Professional Professional Modifier Low / Median / High Price $45.49 / $57.62 / $163.36	Professional		$45.49	$57.62	$163.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.70 / $9.36 / $23.11	Professional	26	$6.70	$9.36	$23.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.40 / $48.66 / $138.94	Professional	TC	$38.40	$48.66	$138.94