Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.86 / $66.86 / $66.86	Facility		$66.86	$66.86	$66.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.09 / $17.09 / $17.09	Facility	26	$17.09	$17.09	$17.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.06 / $79.06 / $139.19	Professional		$60.06	$79.06	$139.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.72 / $17.09 / $17.64	Professional	26	$16.72	$17.09	$17.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.33 / $58.69 / $122.46	Professional	TC	$43.33	$58.69	$122.46
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $72.73 / $80.81 / $154.15	Professional		$72.73	$80.81	$154.15
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $18.82 / $20.91 / $22.79	Professional	26	$18.82	$20.91	$22.79
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $53.91 / $59.90 / $98.83	Professional	TC	$53.91	$59.90	$98.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.82 / $199.62 / $344.75	Professional		$63.82	$199.62	$344.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.39 / $43.77 / $76.25	Professional	26	$19.39	$43.77	$76.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.63 / $147.96 / $253.39	Professional	TC	$46.63	$147.96	$253.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.06 / $159.69 / $159.69	Professional		$71.06	$159.69	$159.69
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 $52.73 / $119.36 / $119.36	Professional	TC	$52.73	$119.36	$119.36
United Facility/Professional Professional Modifier Low / Median / High Price $64.56 / $149.65 / $328.84	Professional		$64.56	$149.65	$328.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.62 / $24.29 / $51.10	Professional	26	$13.62	$24.29	$51.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.61 / $141.04 / $286.50	Professional	TC	$47.61	$141.04	$286.50