Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $141.25 / $302.00	Facility	26	$40.74	$141.25	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $177.83 / $323.59	Professional		$100.00	$177.83	$323.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $64.57 / $144.54	Professional	26	$38.90	$64.57	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $81.28 / $257.04	Professional	TC	$57.54	$81.28	$257.04
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $128.82 / $512.86	Professional		$72.44	$128.82	$512.86
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $50.12 / $128.82	Professional	26	$44.67	$50.12	$128.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $81.28 / $131.83	Professional	TC	$74.13	$81.28	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $147.91 / $309.03	Professional		$102.33	$147.91	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $56.23 / $107.15	Professional	26	$36.31	$56.23	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $89.13 / $199.53	Professional	TC	$57.54	$89.13	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $134.90 / $275.42	Professional		$123.03	$134.90	$275.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $50.12 / $144.54	Professional	26	$47.86	$50.12	$144.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $83.18 / $169.82	Professional	TC	$75.86	$83.18	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $125.89 / $354.81	Professional		$107.15	$125.89	$354.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $48.98 / $131.83	Professional	26	$40.74	$48.98	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $77.62 / $223.87	Professional	TC	$66.07	$77.62	$223.87