Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $173.78 / $371.54	Facility	26	$51.29	$173.78	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $234.42 / $457.09	Professional		$169.82	$234.42	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $75.86 / $190.55	Professional	26	$51.29	$75.86	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $165.96 / $346.74	Professional	TC	$112.20	$165.96	$346.74
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $218.78 / $1,318.26	Professional		$67.61	$218.78	$1,318.26
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $69.18 / $75.86	Professional	26	$63.10	$69.18	$75.86
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $162.18 / $223.87	Professional	TC	$141.25	$162.18	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $331.13 / $645.65	Professional		$194.98	$331.13	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $69.18 / $162.18	Professional	26	$48.98	$69.18	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $275.42 / $512.86	Professional	TC	$144.54	$275.42	$512.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $213.80 / $478.63	Professional		$181.97	$213.80	$478.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $67.61 / $128.82	Professional	26	$57.54	$67.61	$128.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $147.91 / $354.81	Professional	TC	$120.23	$147.91	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $288.40 / $616.60	Professional		$169.82	$288.40	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $72.44 / $194.98	Professional	26	$41.69	$72.44	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $229.09 / $426.58	Professional	TC	$123.03	$229.09	$426.58