Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.76 / $110.73 / $327.47	Facility	26	$45.76	$110.73	$327.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.97 / $135.94 / $158.75	Professional		$125.97	$135.94	$158.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.15 / $45.76 / $100.80	Professional	26	$44.15	$45.76	$100.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.81 / $90.18 / $103.98	Professional	TC	$81.81	$90.18	$103.98
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $195.50 / $249.78 / $284.77	Professional		$195.50	$249.78	$284.77
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $66.48 / $79.93 / $87.12	Professional	26	$66.48	$79.93	$87.12
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $129.01 / $169.85 / $185.14	Professional	TC	$129.01	$169.85	$185.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.41 / $224.82 / $635.79	Professional		$153.41	$224.82	$635.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.08 / $72.51 / $211.74	Professional	26	$43.08	$72.51	$211.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.43 / $146.02 / $424.07	Professional	TC	$99.43	$146.02	$424.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $148.94 / $331.17 / $331.17	Professional		$148.94	$331.17	$331.17
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.16 / $112.63 / $112.63	Professional	26	$51.16	$112.63	$112.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $97.78 / $218.54 / $218.54	Professional	TC	$97.78	$218.54	$218.54
United Facility/Professional Professional Modifier Low / Median / High Price $117.70 / $170.85 / $502.67	Professional		$117.70	$170.85	$502.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.47 / $57.36 / $170.96	Professional	26	$39.47	$57.36	$170.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.26 / $126.48 / $331.71	Professional	TC	$71.26	$126.48	$331.71