Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.11 / $95.58 / $243.55	Facility	26	$34.11	$95.58	$243.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.51 / $119.68 / $143.57	Professional		$110.51	$119.68	$143.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $34.11 / $73.78	Professional	26	$31.76	$34.11	$73.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.64 / $85.57 / $101.23	Professional	TC	$77.64	$85.57	$101.23
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $112.91 / $128.68 / $264.04	Professional		$112.91	$128.68	$264.04
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $34.50 / $36.77 / $39.64	Professional	26	$34.50	$36.77	$39.64
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $80.51 / $90.35 / $98.48	Professional	TC	$80.51	$90.35	$98.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.19 / $150.29 / $518.50	Professional		$100.19	$150.29	$518.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.34 / $51.14 / $143.88	Professional	26	$32.34	$51.14	$143.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.41 / $97.16 / $374.63	Professional	TC	$65.41	$97.16	$374.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.24 / $149.63 / $289.42	Professional		$129.24	$149.63	$289.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.40 / $44.47 / $83.77	Professional	26	$38.40	$44.47	$83.77
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $90.83 / $105.17 / $205.65	Professional	TC	$90.83	$105.17	$205.65
United Facility/Professional Professional Modifier Low / Median / High Price $89.16 / $173.45 / $366.73	Professional		$89.16	$173.45	$366.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.02 / $54.44 / $106.15	Professional	26	$27.02	$54.44	$106.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.20 / $117.32 / $260.58	Professional	TC	$60.20	$117.32	$260.58