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 / $387.76	Facility	26	$54.45	$155.16	$387.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.32 / $147.91 / $267.69	Professional		$137.32	$147.91	$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 $84.80 / $93.47 / $201.28	Professional	TC	$84.80	$93.47	$201.28
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $212.52 / $237.37 / $721.88	Professional		$212.52	$237.37	$721.88
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $61.39 / $66.75 / $78.73	Professional	26	$61.39	$66.75	$78.73
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $133.79 / $170.63 / $185.99	Professional	TC	$133.79	$170.63	$185.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.94 / $285.94 / $695.05	Professional		$201.94	$285.94	$695.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.32 / $88.92 / $252.35	Professional	26	$51.32	$88.92	$252.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.94 / $214.92 / $442.71	Professional	TC	$126.94	$214.92	$442.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.03 / $359.99 / $359.99	Professional		$162.03	$359.99	$359.99
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.94 / $133.37 / $133.37	Professional	26	$60.94	$133.37	$133.37
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $101.09 / $226.63 / $226.63	Professional	TC	$101.09	$226.63	$226.63
United Facility/Professional Professional Modifier Low / Median / High Price $150.38 / $235.46 / $546.41	Professional		$150.38	$235.46	$546.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.26 / $69.19 / $202.43	Professional	26	$49.26	$69.19	$202.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.97 / $148.62 / $351.44	Professional	TC	$89.97	$148.62	$351.44