Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.03 / $222.70 / $433.94	Facility	26	$49.03	$222.70	$433.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $185.86 / $201.75 / $304.60	Professional		$185.86	$201.75	$304.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.30 / $49.03 / $61.29	Professional	26	$47.30	$49.03	$61.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.57 / $152.72 / $255.44	Professional	TC	$138.57	$152.72	$255.44
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $260.02 / $287.93 / $842.51	Professional		$260.02	$287.93	$842.51
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $55.48 / $60.83 / $71.30	Professional	26	$55.48	$60.83	$71.30
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $194.96 / $216.00 / $235.44	Professional	TC	$194.96	$216.00	$235.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $256.26 / $332.85 / $950.81	Professional		$256.26	$332.85	$950.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.19 / $80.68 / $225.44	Professional	26	$46.19	$80.68	$225.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $193.77 / $268.77 / $725.37	Professional	TC	$193.77	$268.77	$725.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $217.84 / $487.73 / $487.73	Professional		$217.84	$487.73	$487.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $54.85 / $120.78 / $120.78	Professional	26	$54.85	$120.78	$120.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $162.97 / $366.94 / $366.94	Professional	TC	$162.97	$366.94	$366.94
United Facility/Professional Professional Modifier Low / Median / High Price $177.06 / $307.95 / $740.30	Professional		$177.06	$307.95	$740.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.72 / $62.30 / $183.33	Professional	26	$39.72	$62.30	$183.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.49 / $223.54 / $556.97	Professional	TC	$114.49	$223.54	$556.97