Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.33 / $56.45 / $165.84	Facility	26	$23.33	$56.45	$165.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.35 / $103.31 / $250.01	Professional		$92.35	$103.31	$250.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.33 / $23.55 / $39.82	Professional	26	$23.33	$23.55	$39.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.76 / $79.98 / $140.53	Professional	TC	$65.76	$79.98	$140.53
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $114.31 / $114.31 / $307.44	Professional		$114.31	$114.31	$307.44
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $30.87 / $31.14 / $33.94	Professional	26	$30.87	$31.14	$33.94
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $83.17 / $83.17 / $90.66	Professional	TC	$83.17	$83.17	$90.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.19 / $126.48 / $348.18	Professional		$87.19	$126.48	$348.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.81 / $32.74 / $80.37	Professional	26	$21.81	$32.74	$80.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.59 / $90.73 / $267.80	Professional	TC	$65.59	$90.73	$267.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.95 / $253.01 / $253.01	Professional		$120.95	$253.01	$253.01
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.26 / $57.04 / $57.04	Professional	26	$27.26	$57.04	$57.04
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $93.69 / $195.97 / $195.97	Professional	TC	$93.69	$195.97	$195.97
United Facility/Professional Professional Modifier Low / Median / High Price $91.69 / $125.79 / $366.60	Professional		$91.69	$125.79	$366.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.19 / $37.22 / $78.51	Professional	26	$23.19	$37.22	$78.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.50 / $91.66 / $283.95	Professional	TC	$68.50	$91.66	$283.95