Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.85 / $153.30 / $420.77	Facility	26	$47.85	$153.30	$420.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.43 / $146.25 / $353.92	Professional		$135.43	$146.25	$353.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.15 / $47.85 / $115.79	Professional	26	$46.15	$47.85	$115.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.27 / $98.41 / $238.15	Professional	TC	$89.27	$98.41	$238.15
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $210.96 / $226.05 / $809.82	Professional		$210.96	$226.05	$809.82
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $58.58 / $63.85 / $96.66	Professional	26	$58.58	$63.85	$96.66
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $141.41 / $167.47 / $276.33	Professional	TC	$141.41	$167.47	$276.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.74 / $319.60 / $689.02	Professional		$184.74	$319.60	$689.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.07 / $78.73 / $221.46	Professional	26	$45.07	$78.73	$221.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.61 / $257.12 / $467.56	Professional	TC	$124.61	$257.12	$467.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $160.83 / $357.35 / $357.35	Professional		$160.83	$357.35	$357.35
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $53.51 / $117.82 / $117.82	Professional	26	$53.51	$117.82	$117.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $107.31 / $239.53 / $239.53	Professional	TC	$107.31	$239.53	$239.53
United Facility/Professional Professional Modifier Low / Median / High Price $130.36 / $234.44 / $542.40	Professional		$130.36	$234.44	$542.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.74 / $60.79 / $178.83	Professional	26	$38.74	$60.79	$178.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.08 / $158.44 / $363.57	Professional	TC	$95.08	$158.44	$363.57