Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.86 / $133.54 / $308.49	Facility	26	$35.86	$133.54	$308.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.88 / $104.65 / $253.25	Professional		$96.88	$104.65	$253.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.86 / $38.60 / $87.56	Professional	26	$35.86	$38.60	$87.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.42 / $68.79 / $166.47	Professional	TC	$62.42	$68.79	$166.47
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $112.61 / $123.67 / $249.73	Professional		$112.61	$123.67	$249.73
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $46.18 / $46.18 / $112.55	Professional	26	$46.18	$46.18	$112.55
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $66.43 / $77.48 / $83.13	Professional	TC	$66.43	$77.48	$83.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.21 / $140.32 / $350.44	Professional		$94.21	$140.32	$350.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.03 / $49.06 / $130.07	Professional	26	$34.03	$49.06	$130.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.74 / $86.20 / $220.37	Professional	TC	$53.74	$86.20	$220.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.96 / $133.74 / $258.36	Professional		$111.96	$133.74	$258.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.40 / $46.79 / $88.99	Professional	26	$40.40	$46.79	$88.99
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $71.56 / $86.93 / $169.36	Professional	TC	$71.56	$86.93	$169.36
United Facility/Professional Professional Modifier Low / Median / High Price $92.97 / $115.13 / $355.63	Professional		$92.97	$115.13	$355.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.36 / $52.59 / $122.50	Professional	26	$33.36	$52.59	$122.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.51 / $75.62 / $233.13	Professional	TC	$60.51	$75.62	$233.13