Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.74 / $166.84 / $455.19	Facility	26	$51.74	$166.84	$455.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.97 / $168.59 / $316.26	Professional		$155.97	$168.59	$316.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.94 / $51.74 / $120.34	Professional	26	$49.94	$51.74	$120.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.04 / $116.84 / $260.23	Professional	TC	$106.04	$116.84	$260.23
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $242.36 / $282.80 / $985.54	Professional		$242.36	$282.80	$985.54
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $58.58 / $63.79 / $75.25	Professional	26	$58.58	$63.79	$75.25
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $167.11 / $219.01 / $245.60	Professional	TC	$167.11	$219.01	$245.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.92 / $388.63 / $794.27	Professional		$240.92	$388.63	$794.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.76 / $84.57 / $241.30	Professional	26	$48.76	$84.57	$241.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.51 / $318.45 / $552.98	Professional	TC	$162.51	$318.45	$552.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $184.62 / $410.54 / $410.54	Professional		$184.62	$410.54	$410.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.89 / $127.47 / $127.47	Professional	26	$57.89	$127.47	$127.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $126.72 / $283.07 / $283.07	Professional	TC	$126.72	$283.07	$283.07
United Facility/Professional Professional Modifier Low / Median / High Price $156.97 / $284.02 / $623.15	Professional		$156.97	$284.02	$623.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.18 / $78.81 / $193.48	Professional	26	$47.18	$78.81	$193.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $118.13 / $199.53 / $445.75	Professional	TC	$118.13	$199.53	$445.75