Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.63 / $99.51 / $258.25	Facility	26	$37.63	$99.51	$258.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.45 / $125.26 / $148.22	Professional		$121.45	$125.26	$148.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $37.63 / $68.47	Professional	26	$31.76	$37.63	$68.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.97 / $89.70 / $98.08	Professional	TC	$88.97	$89.70	$98.08
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $127.14 / $146.74 / $285.77	Professional		$127.14	$146.74	$285.77
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $35.96 / $38.65 / $42.70	Professional	26	$35.96	$38.65	$42.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $92.70 / $104.04 / $113.40	Professional	TC	$92.70	$104.04	$113.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.52 / $162.75 / $591.61	Professional		$111.52	$162.75	$591.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.31 / $51.14 / $160.22	Professional	26	$33.31	$51.14	$160.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.26 / $109.62 / $431.38	Professional	TC	$75.26	$109.62	$431.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $146.04 / $169.10 / $328.02	Professional		$146.04	$169.10	$328.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $42.39 / $49.08 / $93.32	Professional	26	$42.39	$49.08	$93.32
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $103.65 / $120.02 / $234.70	Professional	TC	$103.65	$120.02	$234.70
United Facility/Professional Professional Modifier Low / Median / High Price $110.46 / $307.57 / $415.64	Professional		$110.46	$307.57	$415.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.02 / $61.11 / $118.25	Professional	26	$27.02	$61.11	$118.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.33 / $103.61 / $297.39	Professional	TC	$73.33	$103.61	$297.39