Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.61 / $115.35 / $258.25	Facility	26	$43.61	$115.35	$258.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.85 / $149.26 / $361.20	Professional		$137.85	$149.26	$361.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.01 / $43.61 / $105.53	Professional	26	$42.01	$43.61	$105.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.84 / $105.65 / $255.67	Professional	TC	$95.84	$105.65	$255.67
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $129.21 / $161.03 / $293.30	Professional		$129.21	$161.03	$293.30
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $36.77 / $44.80 / $49.12	Professional	26	$36.77	$44.80	$49.12
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $93.24 / $111.91 / $121.98	Professional	TC	$93.24	$111.91	$121.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.71 / $190.40 / $649.76	Professional		$116.71	$190.40	$649.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.31 / $51.45 / $185.75	Professional	26	$33.31	$51.45	$185.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.20 / $138.76 / $464.01	Professional	TC	$78.20	$138.76	$464.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $161.22 / $186.67 / $361.41	Professional		$161.22	$186.67	$361.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $48.77 / $56.47 / $107.37	Professional	26	$48.77	$56.47	$107.37
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $112.44 / $130.19 / $254.05	Professional	TC	$112.44	$130.19	$254.05
United Facility/Professional Professional Modifier Low / Median / High Price $118.75 / $221.89 / $457.96	Professional		$118.75	$221.89	$457.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.01 / $69.42 / $136.05	Professional	26	$27.01	$69.42	$136.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.74 / $193.95 / $321.91	Professional	TC	$91.74	$193.95	$321.91