Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.81 / $119.15 / $301.52	Facility	26	$41.81	$119.15	$301.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.63 / $145.81 / $247.65	Professional		$134.63	$145.81	$247.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $41.81 / $108.05	Professional	26	$40.29	$41.81	$108.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.35 / $104.00 / $204.25	Professional	TC	$94.35	$104.00	$204.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $224.70 / $230.71 / $722.71	Professional		$224.70	$230.71	$722.71
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $52.67 / $57.41 / $86.91	Professional	26	$52.67	$57.41	$86.91
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $154.83 / $172.03 / $283.85	Professional	TC	$154.83	$172.03	$283.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.51 / $285.39 / $766.54	Professional		$209.51	$285.39	$766.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.67 / $69.51 / $196.48	Professional	26	$39.67	$69.51	$196.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $155.26 / $224.93 / $570.05	Professional	TC	$155.26	$224.93	$570.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $174.92 / $390.81 / $390.81	Professional		$174.92	$390.81	$390.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.10 / $103.71 / $103.71	Professional	26	$47.10	$103.71	$103.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $127.82 / $287.12 / $287.12	Professional	TC	$127.82	$287.12	$287.12
United Facility/Professional Professional Modifier Low / Median / High Price $154.30 / $225.23 / $593.19	Professional		$154.30	$225.23	$593.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.36 / $47.00 / $157.41	Professional	26	$39.36	$47.00	$157.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.62 / $156.50 / $435.77	Professional	TC	$100.62	$156.50	$435.77