Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $186.21 / $302.00	Facility	26	$41.69	$186.21	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $239.88 / $436.52	Professional		$112.20	$239.88	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $93.33 / $151.36	Professional	26	$39.81	$93.33	$151.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $100.00 / $263.03	Professional	TC	$72.44	$100.00	$263.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $151.36 / $512.86	Professional		$50.12	$151.36	$512.86
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $48.98 / $131.83	Professional	26	$44.67	$48.98	$131.83
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $100.00 / $169.82	Professional	TC	$91.20	$100.00	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $158.49 / $363.08	Professional		$117.49	$158.49	$363.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $56.23 / $109.65	Professional	26	$37.15	$56.23	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $97.72 / $251.19	Professional	TC	$77.62	$97.72	$251.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $154.88 / $316.23	Professional		$144.54	$154.88	$316.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $51.29 / $144.54	Professional	26	$48.98	$51.29	$144.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $104.71 / $213.80	Professional	TC	$95.50	$104.71	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $144.54 / $407.38	Professional		$120.23	$144.54	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $48.98 / $134.90	Professional	26	$40.74	$48.98	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $95.50 / $275.42	Professional	TC	$81.28	$95.50	$275.42