Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.50 / $60.25 / $161.63	Facility	26	$50.50	$60.25	$161.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.14 / $113.37 / $146.18	Professional		$92.14	$113.37	$146.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.01 / $22.76 / $53.03	Professional	26	$22.01	$22.76	$53.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.84 / $91.36 / $118.42	Professional	TC	$67.84	$91.36	$118.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $141.44 / $157.46 / $251.11	Professional		$141.44	$157.46	$251.11
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $27.08 / $30.09 / $49.17	Professional	26	$27.08	$30.09	$49.17
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $109.21 / $127.37 / $138.83	Professional	TC	$109.21	$127.37	$138.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.78 / $128.82 / $542.59	Professional		$84.78	$128.82	$542.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.26 / $36.93 / $97.02	Professional	26	$21.26	$36.93	$97.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.23 / $96.56 / $445.57	Professional	TC	$57.23	$96.56	$445.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.47 / $152.22 / $296.73	Professional		$131.47	$152.22	$296.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.25 / $29.24 / $55.59	Professional	26	$25.25	$29.24	$55.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $106.22 / $122.99 / $241.14	Professional	TC	$106.22	$122.99	$241.14
United Facility/Professional Professional Modifier Low / Median / High Price $72.63 / $157.16 / $376.00	Professional		$72.63	$157.16	$376.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.68 / $35.42 / $70.45	Professional	26	$20.68	$35.42	$70.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.61 / $104.30 / $305.55	Professional	TC	$52.61	$104.30	$305.55