Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $245.47 / $380.19	Facility	26	$52.48	$245.47	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $263.03 / $501.19	Professional		$194.98	$263.03	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $64.57 / $138.04	Professional	26	$51.29	$64.57	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $190.55 / $380.19	Professional	TC	$138.04	$190.55	$380.19
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $281.84 / $1,584.89	Professional		$70.79	$281.84	$1,584.89
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $69.18 / $85.11	Professional	26	$54.95	$69.18	$85.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $204.17 / $275.42	Professional	TC	$186.21	$204.17	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $407.38 / $776.25	Professional		$234.42	$407.38	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $169.82	Professional	26	$51.29	$72.44	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $346.74 / $630.96	Professional	TC	$177.83	$346.74	$630.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $251.19 / $562.34	Professional		$208.93	$251.19	$562.34
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $69.18 / $131.83	Professional	26	$60.26	$69.18	$131.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $177.83 / $436.52	Professional	TC	$147.91	$177.83	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $346.74 / $724.44	Professional		$199.53	$346.74	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $75.86 / $199.53	Professional	26	$43.65	$75.86	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $288.40 / $524.81	Professional	TC	$151.36	$288.40	$524.81