Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.35 / $42.35 / $42.35	Facility	26	$42.35	$42.35	$42.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.11 / $95.58 / $100.70	Professional		$93.11	$95.58	$100.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.73 / $53.23 / $54.46	Professional	TC	$50.73	$53.23	$54.46
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $90.97 / $101.07 / $166.77	Professional		$90.97	$101.07	$166.77
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $53.12 / $59.03 / $64.34	Professional	TC	$53.12	$59.03	$64.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.59 / $253.27 / $382.70	Professional		$82.59	$253.27	$382.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.25 / $147.33 / $192.79	Professional	TC	$25.25	$147.33	$192.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $93.40 / $220.20 / $220.20	Professional		$93.40	$220.20	$220.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.07 / $100.07 / $100.07	Professional	26	$45.07	$100.07	$100.07
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.34 / $120.15 / $120.15	Professional	TC	$48.34	$120.15	$120.15
United Facility/Professional Professional Modifier Low / Median / High Price $72.38 / $141.00 / $278.85	Professional		$72.38	$141.00	$278.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.20 / $67.34 / $152.13	Professional	TC	$38.20	$67.34	$152.13