Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.26 / $187.37 / $362.05	Facility	26	$40.26	$187.37	$362.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.40 / $124.52 / $300.00	Professional		$115.40	$124.52	$300.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.95 / $40.26 / $96.54	Professional	26	$38.95	$40.26	$96.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.44 / $84.26 / $203.90	Professional	TC	$76.44	$84.26	$203.90
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $162.08 / $176.67 / $538.39	Professional		$162.08	$176.67	$538.39
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $46.76 / $50.80 / $58.46	Professional	26	$46.76	$50.80	$58.46
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $111.28 / $119.41 / $127.60	Professional	TC	$111.28	$119.41	$127.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.45 / $215.02 / $614.79	Professional		$165.45	$215.02	$614.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.88 / $67.59 / $187.62	Professional	26	$37.88	$67.59	$187.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.60 / $158.97 / $427.17	Professional	TC	$113.60	$158.97	$427.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $137.38 / $164.04 / $315.17	Professional		$137.38	$164.04	$315.17
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.98 / $52.09 / $99.03	Professional	26	$44.98	$52.09	$99.03
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $92.13 / $111.96 / $216.14	Professional	TC	$92.13	$111.96	$216.14
United Facility/Professional Professional Modifier Low / Median / High Price $115.42 / $173.38 / $478.38	Professional		$115.42	$173.38	$478.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.77 / $52.08 / $150.32	Professional	26	$33.77	$52.08	$150.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.20 / $130.56 / $328.06	Professional	TC	$75.20	$130.56	$328.06