Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.03 / $139.74 / $351.17	Facility	26	$49.03	$139.74	$351.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.04 / $165.55 / $307.42	Professional		$153.04	$165.55	$307.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.30 / $49.03 / $123.43	Professional	26	$47.30	$49.03	$123.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $105.74 / $116.52 / $254.24	Professional	TC	$105.74	$116.52	$254.24
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $237.92 / $280.50 / $842.51	Professional		$237.92	$280.50	$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 $166.63 / $219.67 / $239.44	Professional	TC	$166.63	$219.67	$239.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.31 / $332.85 / $778.41	Professional		$236.31	$332.85	$778.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.19 / $80.68 / $226.99	Professional	26	$46.19	$80.68	$226.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.05 / $268.77 / $551.41	Professional	TC	$162.05	$268.77	$551.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $175.14 / $209.40 / $403.02	Professional		$175.14	$209.40	$403.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $54.85 / $63.51 / $120.78	Professional	26	$54.85	$63.51	$120.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $120.10 / $145.88 / $282.26	Professional	TC	$120.10	$145.88	$282.26
United Facility/Professional Professional Modifier Low / Median / High Price $154.44 / $248.18 / $611.73	Professional		$154.44	$248.18	$611.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.82 / $62.30 / $183.33	Professional	26	$44.82	$62.30	$183.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $116.88 / $381.27 / $428.40	Professional	TC	$116.88	$381.27	$428.40