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 $155.02 / $167.60 / $315.56	Professional		$155.02	$167.60	$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 $105.45 / $116.19 / $259.52	Professional	TC	$105.45	$116.19	$259.52
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $240.94 / $282.06 / $984.68	Professional		$240.94	$282.06	$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 $166.15 / $218.27 / $245.63	Professional	TC	$166.15	$218.27	$245.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.48 / $389.41 / $788.06	Professional		$239.48	$389.41	$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 $161.59 / $318.45 / $548.32	Professional	TC	$161.59	$318.45	$548.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $183.53 / $408.13 / $408.13	Professional		$183.53	$408.13	$408.13
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 $125.99 / $281.45 / $281.45	Professional	TC	$125.99	$281.45	$281.45
United Facility/Professional Professional Modifier Low / Median / High Price $141.83 / $284.93 / $619.48	Professional		$141.83	$284.93	$619.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.96 / $65.78 / $192.28	Professional	26	$41.96	$65.78	$192.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.98 / $200.88 / $443.98	Professional	TC	$117.98	$200.88	$443.98