Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $154.88 / $389.05	Facility	26	$53.70	$154.88	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $223.87 / $501.19	Professional		$154.88	$223.87	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $83.18 / $199.53	Professional	26	$54.95	$83.18	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $125.89 / $371.54	Professional	TC	$97.72	$125.89	$371.54
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $223.87 / $954.99	Professional		$70.79	$223.87	$954.99
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $79.43 / $109.65	Professional	26	$67.61	$79.43	$109.65
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $134.90 / $323.59	Professional	TC	$131.83	$134.90	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $288.40 / $676.08	Professional		$199.53	$288.40	$676.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $74.13 / $173.78	Professional	26	$51.29	$74.13	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $213.80 / $478.63	Professional	TC	$144.54	$213.80	$478.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $199.53 / $478.63	Professional		$169.82	$199.53	$478.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $70.79 / $134.90	Professional	26	$61.66	$70.79	$134.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $128.82 / $354.81	Professional	TC	$107.15	$128.82	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $288.40 / $575.44	Professional		$165.96	$288.40	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $75.86 / $204.17	Professional	26	$43.65	$75.86	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $234.42 / $380.19	Professional	TC	$117.49	$234.42	$380.19