Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.03 / $76.36 / $205.02	Facility	26	$24.03	$76.36	$205.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.64 / $117.53 / $128.04	Professional		$81.64	$117.53	$128.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.18 / $24.03 / $25.14	Professional	26	$23.18	$24.03	$25.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.70 / $97.41 / $104.00	Professional	TC	$83.70	$97.41	$104.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $124.39 / $145.99 / $317.75	Professional		$124.39	$145.99	$317.75
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $26.44 / $29.38 / $48.48	Professional	26	$26.44	$29.38	$48.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $97.95 / $116.60 / $175.79	Professional	TC	$97.95	$116.60	$175.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.35 / $145.63 / $553.73	Professional		$104.35	$145.63	$553.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.77 / $37.88 / $102.49	Professional	26	$22.77	$37.88	$102.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.23 / $105.15 / $451.24	Professional	TC	$78.23	$105.15	$451.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.85 / $313.58 / $313.58	Professional		$139.85	$313.58	$313.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.04 / $58.75 / $58.75	Professional	26	$27.04	$58.75	$58.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $112.81 / $254.86 / $254.86	Professional	TC	$112.81	$254.86	$254.86
United Facility/Professional Professional Modifier Low / Median / High Price $95.52 / $259.50 / $397.35	Professional		$95.52	$259.50	$397.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.95 / $29.71 / $74.44	Professional	26	$20.95	$29.71	$74.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.16 / $138.03 / $322.91	Professional	TC	$66.16	$138.03	$322.91