Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.85 / $136.36 / $342.54	Facility	26	$47.85	$136.36	$342.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.22 / $180.16 / $372.00	Professional		$166.22	$180.16	$372.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.15 / $47.85 / $64.19	Professional	26	$46.15	$47.85	$64.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.07 / $132.31 / $308.85	Professional	TC	$120.07	$132.31	$308.85
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $258.56 / $280.07 / $843.72	Professional		$258.56	$280.07	$843.72
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $65.42 / $71.92 / $79.22	Professional	26	$65.42	$71.92	$79.22
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $186.65 / $207.38 / $274.36	Professional	TC	$186.65	$207.38	$274.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $256.25 / $402.18 / $847.44	Professional		$256.25	$402.18	$847.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.07 / $82.38 / $219.91	Professional	26	$45.07	$82.38	$219.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $183.79 / $299.80 / $639.76	Professional	TC	$183.79	$299.80	$639.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $196.36 / $437.99 / $437.99	Professional		$196.36	$437.99	$437.99
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 $142.84 / $320.17 / $320.17	Professional	TC	$142.84	$320.17	$320.17
United Facility/Professional Professional Modifier Low / Median / High Price $192.95 / $306.62 / $664.80	Professional		$192.95	$306.62	$664.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.04 / $76.31 / $178.83	Professional	26	$47.04	$76.31	$178.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $133.68 / $274.56 / $558.76	Professional	TC	$133.68	$274.56	$558.76