Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.02 / $81.67 / $208.00	Facility	26	$25.02	$81.67	$208.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.09 / $116.63 / $131.46	Professional		$101.09	$116.63	$131.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.08 / $25.02 / $30.34	Professional	26	$24.08	$25.02	$30.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.26 / $92.56 / $102.03	Professional	TC	$75.26	$92.56	$102.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $116.69 / $140.87 / $318.60	Professional		$116.69	$140.87	$318.60
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $27.91 / $31.01 / $39.00	Professional	26	$27.91	$31.01	$39.00
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $85.68 / $109.86 / $119.75	Professional	TC	$85.68	$109.86	$119.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.29 / $148.05 / $563.73	Professional		$98.29	$148.05	$563.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.69 / $40.13 / $108.23	Professional	26	$23.69	$40.13	$108.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.13 / $105.15 / $455.50	Professional	TC	$71.13	$105.15	$455.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.72 / $307.10 / $307.10	Professional		$134.72	$307.10	$307.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.13 / $62.73 / $62.73	Professional	26	$28.13	$62.73	$62.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $106.58 / $244.37 / $244.37	Professional	TC	$106.58	$244.37	$244.37
United Facility/Professional Professional Modifier Low / Median / High Price $78.45 / $125.23 / $389.14	Professional		$78.45	$125.23	$389.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.21 / $40.52 / $79.48	Professional	26	$21.21	$40.52	$79.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.34 / $139.10 / $309.64	Professional	TC	$58.34	$139.10	$309.64