Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $165.96 / $426.58	Facility	26	$57.54	$165.96	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $288.40 / $645.65	Professional		$218.78	$288.40	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $85.11 / $177.83	Professional	26	$57.54	$85.11	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $213.80 / $602.56	Professional	TC	$162.18	$213.80	$602.56
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $371.54 / $1,548.82	Professional		$85.11	$371.54	$1,548.82
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $79.43 / $134.90	Professional	26	$72.44	$79.43	$134.90
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $269.15 / $524.81	Professional	TC	$257.04	$269.15	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $436.52 / $794.33	Professional		$229.09	$436.52	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $79.43 / $186.21	Professional	26	$56.23	$79.43	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $354.81 / $630.96	Professional	TC	$165.96	$354.81	$630.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $302.00 / $630.96	Professional		$275.42	$302.00	$630.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $69.18 / $144.54	Professional	26	$66.07	$69.18	$144.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $229.09 / $489.78	Professional	TC	$208.93	$229.09	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $407.38 / $977.24	Professional		$239.88	$407.38	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $85.11 / $218.78	Professional	26	$47.86	$85.11	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $309.03 / $741.31	Professional	TC	$177.83	$309.03	$741.31