Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $151.36 / $380.19	Facility	26	$52.48	$151.36	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $275.42 / $588.84	Professional		$194.98	$275.42	$588.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $81.28 / $194.98	Professional	26	$54.95	$81.28	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $190.55 / $436.52	Professional	TC	$134.90	$190.55	$436.52
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $281.84 / $1,621.81	Professional		$70.79	$281.84	$1,621.81
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $75.86 / $131.83	Professional	26	$64.57	$75.86	$131.83
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $204.17 / $549.54	Professional	TC	$181.97	$204.17	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $407.38 / $776.25	Professional		$234.42	$407.38	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $75.86 / $165.96	Professional	26	$50.12	$75.86	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $323.59 / $630.96	Professional	TC	$177.83	$323.59	$630.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $245.47 / $478.63	Professional		$208.93	$245.47	$478.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $69.18 / $134.90	Professional	26	$58.88	$69.18	$134.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $177.83 / $346.74	Professional	TC	$147.91	$177.83	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $346.74 / $724.44	Professional		$199.53	$346.74	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $83.18 / $194.98	Professional	26	$46.77	$83.18	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $288.40 / $524.81	Professional	TC	$147.91	$288.40	$524.81