Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.45 / $155.16 / $390.12	Facility	26	$54.45	$155.16	$390.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.07 / $156.47 / $267.69	Professional		$145.07	$156.47	$267.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.52 / $54.45 / $126.74	Professional	26	$52.52	$54.45	$126.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.56 / $102.03 / $201.28	Professional	TC	$92.56	$102.03	$201.28
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $225.84 / $268.57 / $721.88	Professional		$225.84	$268.57	$721.88
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $67.15 / $73.19 / $110.80	Professional	26	$67.15	$73.19	$110.80
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $146.63 / $201.42 / $311.38	Professional	TC	$146.63	$201.42	$311.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $225.11 / $340.03 / $735.43	Professional		$225.11	$340.03	$735.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.32 / $88.45 / $252.35	Professional	26	$51.32	$88.45	$252.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $148.46 / $246.32 / $541.52	Professional	TC	$148.46	$246.32	$541.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $171.91 / $382.55 / $382.55	Professional		$171.91	$382.55	$382.55
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.94 / $134.18 / $134.18	Professional	26	$60.94	$134.18	$134.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $110.97 / $248.38 / $248.38	Professional	TC	$110.97	$248.38	$248.38
United Facility/Professional Professional Modifier Low / Median / High Price $159.93 / $288.86 / $615.57	Professional		$159.93	$288.86	$615.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.95 / $59.77 / $203.66	Professional	26	$43.95	$59.77	$203.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.88 / $210.30 / $468.01	Professional	TC	$112.88	$210.30	$468.01