Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $97.72 / $245.47	Facility	26	$33.88	$97.72	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $117.49 / $281.84	Professional		$89.13	$117.49	$281.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $61.66 / $114.82	Professional	26	$30.90	$61.66	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $81.28 / $158.49	Professional	TC	$63.10	$81.28	$158.49
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $125.89 / $354.81	Professional		$40.74	$125.89	$354.81
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $36.31 / $43.65	Professional	26	$33.11	$36.31	$43.65
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $85.11 / $95.50	Professional	TC	$63.10	$85.11	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $134.90 / $302.00	Professional		$97.72	$134.90	$302.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $38.90 / $102.33	Professional	26	$29.51	$38.90	$102.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $93.33 / $218.78	Professional	TC	$64.57	$93.33	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $141.25 / $288.40	Professional		$128.82	$141.25	$288.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $40.74 / $83.18	Professional	26	$38.90	$40.74	$83.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $100.00 / $204.17	Professional	TC	$91.20	$100.00	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $144.54 / $363.08	Professional		$87.10	$144.54	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $48.98 / $107.15	Professional	26	$26.92	$48.98	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $97.72 / $263.03	Professional	TC	$60.26	$97.72	$263.03