Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $169.82 / $363.08	Facility	26	$50.12	$169.82	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $173.78 / $389.05	Professional		$128.82	$173.78	$389.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $77.62 / $186.21	Professional	26	$51.29	$77.62	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $102.33 / $275.42	Professional	TC	$77.62	$102.33	$275.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $208.93 / $1,071.52	Professional		$97.72	$208.93	$1,071.52
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $66.07 / $114.82	Professional	26	$61.66	$66.07	$114.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $117.49 / $141.25	Professional	TC	$107.15	$117.49	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $269.15 / $426.58	Professional		$125.89	$269.15	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $67.61 / $158.49	Professional	26	$47.86	$67.61	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $199.53 / $331.13	Professional	TC	$77.62	$199.53	$331.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $154.88 / $331.13	Professional		$144.54	$154.88	$331.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $60.26 / $123.03	Professional	26	$56.23	$60.26	$123.03
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $95.50 / $204.17	Professional	TC	$87.10	$95.50	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $223.87 / $501.19	Professional		$128.82	$223.87	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $70.79 / $186.21	Professional	26	$40.74	$70.79	$186.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $162.18 / $309.03	Professional	TC	$89.13	$162.18	$309.03