Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.66 / $112.91 / $333.97	Facility	26	$46.66	$112.91	$333.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.46 / $203.65 / $247.00	Professional		$187.46	$203.65	$247.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.01 / $46.66 / $62.04	Professional	26	$45.01	$46.66	$62.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $142.44 / $157.00 / $184.95	Professional	TC	$142.44	$157.00	$184.95
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $283.02 / $283.55 / $560.26	Professional		$283.02	$283.55	$560.26
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $56.15 / $62.39 / $68.01	Professional	26	$56.15	$62.39	$68.01
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $199.25 / $220.63 / $240.49	Professional	TC	$199.25	$220.63	$240.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.15 / $374.70 / $964.68	Professional		$239.15	$374.70	$964.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.94 / $78.06 / $215.94	Professional	26	$43.94	$78.06	$215.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $180.39 / $262.62 / $748.74	Professional	TC	$180.39	$262.62	$748.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $210.12 / $252.10 / $489.88	Professional		$210.12	$252.10	$489.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $52.17 / $60.41 / $114.87	Professional	26	$52.17	$60.41	$114.87
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $157.76 / $191.69 / $375.01	Professional	TC	$157.76	$191.69	$375.01
United Facility/Professional Professional Modifier Low / Median / High Price $179.83 / $256.16 / $754.66	Professional		$179.83	$256.16	$754.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.36 / $60.08 / $176.95	Professional	26	$41.36	$60.08	$176.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.31 / $196.08 / $577.71	Professional	TC	$138.31	$196.08	$577.71