Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.41 / $166.84 / $455.19	Facility	26	$51.41	$166.84	$455.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.72 / $167.27 / $315.56	Professional		$154.72	$167.27	$315.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.58 / $51.41 / $120.34	Professional	26	$49.58	$51.41	$120.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $105.15 / $115.86 / $259.87	Professional	TC	$105.15	$115.86	$259.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $240.47 / $282.80 / $984.68	Professional		$240.47	$282.80	$984.68
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $58.28 / $63.79 / $74.78	Professional	26	$58.28	$63.79	$74.78
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $165.68 / $219.01 / $245.63	Professional	TC	$165.68	$219.01	$245.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.01 / $388.63 / $788.06	Professional		$239.01	$388.63	$788.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.45 / $84.57 / $239.74	Professional	26	$48.45	$84.57	$239.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $161.12 / $318.45 / $548.32	Professional	TC	$161.12	$318.45	$548.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $182.80 / $407.33 / $407.33	Professional		$182.80	$407.33	$407.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $126.68 / $126.68	Professional	26	$57.54	$126.68	$126.68
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $125.26 / $280.64 / $280.64	Professional	TC	$125.26	$280.64	$280.64
United Facility/Professional Professional Modifier Low / Median / High Price $155.86 / $284.93 / $618.27	Professional		$155.86	$284.93	$618.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.91 / $141.11 / $192.28	Professional	26	$46.91	$141.11	$192.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $118.13 / $199.38 / $445.75	Professional	TC	$118.13	$199.38	$445.75