Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.57 / $115.73 / $256.32	Facility	26	$83.57	$115.73	$256.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.00 / $104.66 / $205.37	Professional		$97.00	$104.66	$205.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.58 / $35.86 / $84.27	Professional	26	$34.58	$35.86	$84.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.42 / $68.79 / $160.87	Professional	TC	$62.42	$68.79	$160.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $150.59 / $162.51 / $663.07	Professional		$150.59	$162.51	$663.07
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $44.12 / $48.09 / $72.80	Professional	26	$44.12	$48.09	$72.80
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $98.56 / $118.39 / $195.34	Professional	TC	$98.56	$118.39	$195.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.13 / $262.14 / $488.79	Professional		$135.13	$262.14	$488.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.02 / $58.82 / $165.67	Professional	26	$34.02	$58.82	$165.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.03 / $202.68 / $323.12	Professional	TC	$90.03	$202.68	$323.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $115.48 / $255.08 / $255.08	Professional		$115.48	$255.08	$255.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.40 / $88.16 / $88.16	Professional	26	$40.40	$88.16	$88.16
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $75.08 / $166.95 / $166.95	Professional	TC	$75.08	$166.95	$166.95
United Facility/Professional Professional Modifier Low / Median / High Price $96.64 / $180.38 / $387.18	Professional		$96.64	$180.38	$387.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.30 / $46.08 / $133.81	Professional	26	$29.30	$46.08	$133.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.94 / $143.08 / $253.37	Professional	TC	$71.94	$143.08	$253.37