Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.32 / $93.47 / $264.20	Facility	26	$28.32	$93.47	$264.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.32 / $131.99 / $241.69	Professional		$121.32	$131.99	$241.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.27 / $29.08 / $50.03	Professional	26	$27.27	$29.08	$50.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.05 / $103.68 / $189.78	Professional	TC	$94.05	$103.68	$189.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $181.74 / $220.10 / $333.18	Professional		$181.74	$220.10	$333.18
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.35 / $36.36 / $81.44	Professional	26	$33.35	$36.36	$81.44
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $149.01 / $165.56 / $187.44	Professional	TC	$149.01	$165.56	$187.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.35 / $173.92 / $582.11	Professional		$101.35	$173.92	$582.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.19 / $39.90 / $96.16	Professional	26	$27.19	$39.90	$96.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.88 / $118.06 / $497.79	Professional	TC	$64.88	$118.06	$497.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $204.39 / $246.47 / $480.79	Professional		$204.39	$246.47	$480.79
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.33 / $37.39 / $71.08	Professional	26	$32.33	$37.39	$71.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $172.06 / $209.08 / $409.69	Professional	TC	$172.06	$209.08	$409.69
United Facility/Professional Professional Modifier Low / Median / High Price $112.33 / $173.57 / $696.65	Professional		$112.33	$173.57	$696.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.90 / $35.97 / $103.00	Professional	26	$27.90	$35.97	$103.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.32 / $169.21 / $593.65	Professional	TC	$89.32	$169.21	$593.65