Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.18 / $185.65 / $362.11	Facility	26	$42.18	$185.65	$362.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.40 / $130.07 / $301.88	Professional		$124.40	$130.07	$301.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.18 / $44.14 / $98.88	Professional	26	$42.18	$44.14	$98.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.81 / $87.88 / $150.71	Professional	TC	$83.81	$87.88	$150.71
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $155.76 / $155.76 / $380.73	Professional		$155.76	$155.76	$380.73
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $52.81 / $52.81 / $127.13	Professional	26	$52.81	$52.81	$127.13
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $94.85 / $102.95 / $182.98	Professional	TC	$94.85	$102.95	$182.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $177.85 / $429.96	Professional		$120.23	$177.85	$429.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.01 / $56.98 / $148.91	Professional	26	$40.01	$56.98	$148.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.38 / $121.40 / $281.04	Professional	TC	$78.38	$121.40	$281.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.77 / $165.69 / $319.13	Professional		$138.77	$165.69	$319.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.61 / $103.81 / $103.81	Professional	26	$47.61	$103.81	$103.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $91.16 / $143.00 / $215.32	Professional	TC	$91.16	$143.00	$215.32
United Facility/Professional Professional Modifier Low / Median / High Price $118.90 / $185.39 / $439.29	Professional		$118.90	$185.39	$439.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.68 / $53.82 / $150.41	Professional	26	$37.68	$53.82	$150.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.36 / $98.13 / $296.39	Professional	TC	$78.36	$98.13	$296.39