Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $107.15 / $229.09	Facility	26	$32.36	$107.15	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $158.49 / $275.42	Professional		$77.62	$158.49	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $70.79 / $109.65	Professional	26	$30.20	$70.79	$109.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $64.57 / $208.93	Professional	TC	$45.71	$64.57	$208.93
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $102.33 / $371.54	Professional		$64.57	$102.33	$371.54
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $37.15 / $60.26	Professional	26	$33.88	$37.15	$60.26
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $67.61 / $134.90	Professional	TC	$58.88	$67.61	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $112.20 / $251.19	Professional		$81.28	$112.20	$251.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $42.66 / $83.18	Professional	26	$27.54	$42.66	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $67.61 / $162.18	Professional	TC	$50.12	$67.61	$162.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $107.15 / $218.78	Professional		$97.72	$107.15	$218.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $38.90 / $100.00	Professional	26	$37.15	$38.90	$100.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $67.61 / $138.04	Professional	TC	$61.66	$67.61	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $100.00 / $281.84	Professional		$83.18	$100.00	$281.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $37.15 / $102.33	Professional	26	$30.20	$37.15	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $63.10 / $177.83	Professional	TC	$53.70	$63.10	$177.83