Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.81 / $119.15 / $301.52	Facility	26	$41.81	$119.15	$301.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.52 / $128.04 / $255.01	Professional		$118.52	$128.04	$255.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $46.89 / $101.18	Professional	26	$40.29	$46.89	$101.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.23 / $86.23 / $201.03	Professional	TC	$78.23	$86.23	$201.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $185.00 / $229.93 / $842.51	Professional		$185.00	$229.93	$842.51
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $55.10 / $60.19 / $91.11	Professional	26	$55.10	$60.19	$91.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $123.79 / $174.71 / $288.27	Professional	TC	$123.79	$174.71	$288.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.13 / $332.85 / $603.47	Professional		$184.13	$332.85	$603.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.67 / $71.91 / $196.48	Professional	26	$39.67	$71.91	$196.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.35 / $253.39 / $410.54	Professional	TC	$120.35	$253.39	$410.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $140.87 / $313.38 / $313.38	Professional		$140.87	$313.38	$313.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.10 / $103.71 / $103.71	Professional	26	$47.10	$103.71	$103.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $93.77 / $209.69 / $209.69	Professional	TC	$93.77	$209.69	$209.69
United Facility/Professional Professional Modifier Low / Median / High Price $134.36 / $224.30 / $475.67	Professional		$134.36	$224.30	$475.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.33 / $67.76 / $157.41	Professional	26	$39.33	$67.76	$157.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.48 / $159.43 / $354.06	Professional	TC	$82.48	$159.43	$354.06