Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.85 / $136.19 / $362.11	Facility	26	$41.85	$136.19	$362.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.95 / $112.29 / $271.74	Professional		$111.95	$112.29	$271.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.85 / $42.60 / $72.81	Professional	26	$41.85	$42.60	$72.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.43 / $71.34 / $120.84	Professional	TC	$70.43	$71.34	$120.84
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $138.38 / $138.38 / $380.73	Professional		$138.38	$138.38	$380.73
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $52.00 / $52.00 / $127.13	Professional	26	$52.00	$52.00	$127.13
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $77.76 / $86.39 / $125.81	Professional	TC	$77.76	$86.39	$125.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.93 / $151.29 / $372.84	Professional		$102.93	$151.29	$372.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.70 / $57.27 / $146.96	Professional	26	$39.70	$57.27	$146.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.07 / $96.98 / $225.89	Professional	TC	$57.07	$96.98	$225.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.21 / $143.22 / $274.77	Professional		$120.21	$143.22	$274.77
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.26 / $103.00 / $103.00	Professional	26	$47.26	$103.00	$103.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $72.95 / $143.00 / $171.78	Professional	TC	$72.95	$143.00	$171.78
United Facility/Professional Professional Modifier Low / Median / High Price $105.83 / $175.20 / $398.15	Professional		$105.83	$175.20	$398.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.97 / $53.82 / $141.78	Professional	26	$37.97	$53.82	$141.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.70 / $80.69 / $248.91	Professional	TC	$65.70	$80.69	$248.91