Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $165.96 / $309.03	Facility		$70.79	$165.96	$309.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $87.10 / $91.20	Facility	26	$38.02	$87.10	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $102.33 / $398.11	Professional		$61.66	$102.33	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $61.66 / $269.15	Professional	26	$36.31	$61.66	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $37.15 / $169.82	Professional	TC	$25.70	$37.15	$169.82
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $74.13 / $707.95	Professional		$38.90	$74.13	$707.95
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $36.31 / $114.82	Professional	26	$36.31	$36.31	$114.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $33.88 / $40.74	Professional	TC	$30.20	$33.88	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $229.09 / $346.74	Professional		$83.18	$229.09	$346.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $93.33 / $173.78	Professional	26	$48.98	$93.33	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $102.33 / $199.53	Professional	TC	$34.67	$102.33	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $83.18 / $147.91	Professional		$70.79	$83.18	$147.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $44.67 / $81.28	Professional	26	$38.90	$44.67	$81.28
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $38.02 / $67.61	Professional	TC	$33.11	$38.02	$67.61
United Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $549.54 / $1,548.82	Facility		$213.80	$549.54	$1,548.82
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $162.18 / $257.04	Professional		$87.10	$162.18	$257.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $79.43 / $104.71	Professional	26	$50.12	$79.43	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $77.62 / $162.18	Professional	TC	$38.02	$77.62	$162.18