Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.79 / $196.03 / $1,109.06	Facility		$126.79	$196.03	$1,109.06
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.37 / $76.28 / $190.78	Facility	26	$62.37	$76.28	$190.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.06 / $66.26 / $201.18	Professional		$51.06	$66.26	$201.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.94 / $29.18 / $64.78	Professional	26	$25.94	$29.18	$64.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.65 / $27.65 / $170.38	Professional	TC	$27.65	$27.65	$170.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $63.59 / $63.59 / $412.88	Professional		$63.59	$63.59	$412.88
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.65 / $33.65 / $85.19	Professional	26	$33.65	$33.65	$85.19
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $29.93 / $29.93 / $157.83	Professional	TC	$29.93	$29.93	$157.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.89 / $151.56 / $271.00	Professional		$48.89	$151.56	$271.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.40 / $39.08 / $92.91	Professional	26	$25.40	$39.08	$92.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.52 / $80.40 / $210.77	Professional	TC	$23.52	$80.40	$210.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.29 / $134.16 / $134.16	Professional		$65.29	$134.16	$134.16
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.75 / $65.62 / $65.62	Professional	26	$31.75	$65.62	$65.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.54 / $68.54 / $68.54	Professional	TC	$33.54	$68.54	$68.54
United Facility/Professional Professional Modifier Low / Median / High Price $52.62 / $80.77 / $194.39	Professional		$52.62	$80.77	$194.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.18 / $34.11 / $95.07	Professional	26	$26.18	$34.11	$95.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.40 / $38.10 / $127.14	Professional	TC	$25.40	$38.10	$127.14