Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.60 / $149.90 / $376.88	Facility	26	$52.60	$149.90	$376.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.63 / $195.77 / $389.06	Professional		$180.63	$195.77	$389.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.72 / $52.60 / $136.12	Professional	26	$50.72	$52.60	$136.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $129.91 / $143.16 / $326.12	Professional	TC	$129.91	$143.16	$326.12
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $280.77 / $343.74 / $1,212.25	Professional		$280.77	$343.74	$1,212.25
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $68.87 / $76.52 / $118.04	Professional	26	$68.87	$76.52	$118.04
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $204.25 / $272.20 / $449.13	Professional	TC	$204.25	$272.20	$449.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.30 / $478.43 / $927.22	Professional		$278.30	$478.43	$927.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.88 / $90.53 / $246.82	Professional	26	$49.88	$90.53	$246.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $197.28 / $397.97 / $680.40	Professional	TC	$197.28	$397.97	$680.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $213.43 / $475.61 / $475.61	Professional		$213.43	$475.61	$475.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.24 / $129.63 / $129.63	Professional	26	$59.24	$129.63	$129.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $154.19 / $345.99 / $345.99	Professional	TC	$154.19	$345.99	$345.99
United Facility/Professional Professional Modifier Low / Median / High Price $185.05 / $305.30 / $721.91	Professional		$185.05	$305.30	$721.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.18 / $88.78 / $196.75	Professional	26	$47.18	$88.78	$196.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $148.97 / $245.84 / $525.16	Professional	TC	$148.97	$245.84	$525.16