Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $112.20 / $331.13	Facility	26	$45.71	$112.20	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $199.53 / $263.03	Professional		$177.83	$199.53	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $50.12 / $131.83	Professional	26	$42.66	$50.12	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $151.36 / $204.17	Professional	TC	$134.90	$151.36	$204.17
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $229.09 / $776.25	Professional		$194.98	$229.09	$776.25
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $53.70 / $54.95	Professional	26	$48.98	$53.70	$54.95
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $173.78 / $190.55	Professional	TC	$158.49	$173.78	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $281.84 / $602.56	Professional		$204.17	$281.84	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $64.57 / $147.91	Professional	26	$44.67	$64.57	$147.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $218.78 / $457.09	Professional	TC	$158.49	$218.78	$457.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $229.09 / $489.78	Professional		$208.93	$229.09	$489.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $54.95 / $114.82	Professional	26	$51.29	$54.95	$114.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $173.78 / $389.05	Professional	TC	$158.49	$173.78	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $281.84 / $758.58	Professional		$165.96	$281.84	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $63.10 / $177.83	Professional	26	$38.90	$63.10	$177.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $218.78 / $575.44	Professional	TC	$125.89	$218.78	$575.44