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 $118.22 / $127.71 / $247.65	Professional		$118.22	$127.71	$247.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $41.81 / $101.18	Professional	26	$40.29	$41.81	$101.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.94 / $85.90 / $201.03	Professional	TC	$77.94	$85.90	$201.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $184.06 / $225.43 / $722.71	Professional		$184.06	$225.43	$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 $122.83 / $172.76 / $285.05	Professional	TC	$122.83	$172.76	$285.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.20 / $285.39 / $600.36	Professional		$183.20	$285.39	$600.36
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 $119.43 / $224.93 / $404.66	Professional	TC	$119.43	$224.93	$404.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $136.22 / $162.68 / $311.77	Professional		$136.22	$162.68	$311.77
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.10 / $54.54 / $103.71	Professional	26	$47.10	$54.54	$103.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $88.99 / $108.14 / $208.07	Professional	TC	$88.99	$108.14	$208.07
United Facility/Professional Professional Modifier Low / Median / High Price $123.57 / $223.25 / $473.23	Professional		$123.57	$223.25	$473.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.49 / $56.47 / $157.41	Professional	26	$37.49	$56.47	$157.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.62 / $300.02 / $315.82	Professional	TC	$93.62	$300.02	$315.82