Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.75 / $40.53 / $45.46	Facility	26	$16.75	$40.53	$45.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $59.75 / $150.91	Professional		$54.52	$59.75	$150.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $16.75 / $31.48	Professional	26	$16.39	$16.75	$31.48
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $29.74 / $31.18 / $31.18	Professional	52	$29.74	$31.18	$31.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.11 / $42.75 / $85.74	Professional	TC	$38.11	$42.75	$85.74
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $57.56 / $63.95 / $69.70	Professional		$57.56	$63.95	$69.70
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.06 / $16.73 / $18.23	Professional	26	$15.06	$16.73	$18.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $42.50 / $47.22 / $51.47	Professional	TC	$42.50	$47.22	$51.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.61 / $158.12 / $260.41	Professional		$62.61	$158.12	$260.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.39 / $43.90 / $76.25	Professional	26	$19.39	$43.90	$76.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.90 / $113.45 / $184.16	Professional	TC	$41.90	$113.45	$184.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.11 / $145.99 / $145.99	Professional		$64.11	$145.99	$145.99
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.32 / $40.35 / $40.35	Professional	26	$18.32	$40.35	$40.35
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $45.79 / $105.66 / $105.66	Professional	TC	$45.79	$105.66	$105.66
United Facility/Professional Professional Modifier Low / Median / High Price $50.71 / $83.35 / $184.87	Professional		$50.71	$83.35	$184.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.23 / $24.29 / $51.10	Professional	26	$15.23	$24.29	$51.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.47 / $59.06 / $133.77	Professional	TC	$35.47	$59.06	$133.77