Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.83 / $271.52 / $529.66	Facility	26	$53.83	$271.52	$529.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.92 / $183.84 / $401.84	Professional		$169.92	$183.84	$401.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.94 / $53.83 / $86.13	Professional	26	$51.94	$53.83	$86.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $117.98 / $130.01 / $314.62	Professional	TC	$117.98	$130.01	$314.62
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $263.04 / $287.83 / $1,011.54	Professional		$263.04	$287.83	$1,011.54
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $70.06 / $77.84 / $122.38	Professional	26	$70.06	$77.84	$122.38
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $185.20 / $213.67 / $352.56	Professional	TC	$185.20	$213.67	$352.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $249.30 / $399.86 / $867.68	Professional		$249.30	$399.86	$867.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.43 / $87.96 / $249.47	Professional	26	$50.43	$87.96	$249.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $180.09 / $321.77 / $659.08	Professional	TC	$180.09	$321.77	$659.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.79 / $445.57 / $445.57	Professional		$199.79	$445.57	$445.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.89 / $131.86 / $131.86	Professional	26	$59.89	$131.86	$131.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $139.91 / $313.70 / $313.70	Professional	TC	$139.91	$313.70	$313.70
United Facility/Professional Professional Modifier Low / Median / High Price $171.97 / $352.82 / $676.31	Professional		$171.97	$352.82	$676.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.42 / $68.42 / $200.15	Professional	26	$48.42	$68.42	$200.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.55 / $290.22 / $569.15	Professional	TC	$138.55	$290.22	$569.15