Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $120.23 / $302.00	Facility	26	$40.74	$120.23	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $177.83 / $588.84	Professional		$128.82	$177.83	$588.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $50.12 / $169.82	Professional	26	$39.81	$50.12	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $120.23 / $338.84	Professional	TC	$83.18	$120.23	$338.84
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $186.21 / $1,122.02	Professional		$112.20	$186.21	$1,122.02
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $56.23 / $100.00	Professional	26	$54.95	$56.23	$100.00
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $123.03 / $407.38	Professional	TC	$109.65	$123.03	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $281.84 / $524.81	Professional		$158.49	$281.84	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $64.57 / $131.83	Professional	26	$39.81	$64.57	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $223.87 / $407.38	Professional	TC	$112.20	$223.87	$407.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $165.96 / $380.19	Professional		$138.04	$165.96	$380.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $54.95 / $104.71	Professional	26	$47.86	$54.95	$104.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $109.65 / $275.42	Professional	TC	$91.20	$109.65	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $229.09 / $478.63	Professional		$134.90	$229.09	$478.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $60.26 / $158.49	Professional	26	$38.90	$60.26	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $186.21 / $316.23	Professional	TC	$95.50	$186.21	$316.23