Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.06 / $347.58 / $1,223.14	Facility		$85.06	$347.58	$1,223.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.98 / $68.48 / $170.80	Facility	26	$55.98	$68.48	$170.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.90 / $112.90 / $273.20	Professional		$112.90	$112.90	$273.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.03 / $24.03 / $88.45	Professional	26	$24.03	$24.03	$88.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.86 / $88.86 / $215.04	Professional	TC	$88.86	$88.86	$215.04
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $85.60 / $131.05 / $239.94	Professional		$85.60	$131.05	$239.94
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $28.99 / $31.79 / $34.52	Professional	26	$28.99	$31.79	$34.52
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $56.61 / $99.26 / $100.35	Professional	TC	$56.61	$99.26	$100.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.42 / $117.53 / $569.61	Professional		$91.42	$117.53	$569.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.47 / $36.07 / $120.56	Professional	26	$21.47	$36.07	$120.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.45 / $82.69 / $449.04	Professional	TC	$65.45	$82.69	$449.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.09 / $275.67 / $275.67	Professional		$129.09	$275.67	$275.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.08 / $58.75 / $58.75	Professional	26	$28.08	$58.75	$58.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $101.01 / $216.95 / $216.95	Professional	TC	$101.01	$216.95	$216.95
United Facility/Professional Professional Modifier Low / Median / High Price $74.36 / $331.85 / $349.32	Professional		$74.36	$331.85	$349.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.84 / $31.52 / $74.44	Professional	26	$23.84	$31.52	$74.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.27 / $79.68 / $274.88	Professional	TC	$51.27	$79.68	$274.88