Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.90 / $159.84 / $316.97	Facility	26	$118.90	$159.84	$316.97
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $130.74 / $166.31 / $700.06	Professional		$130.74	$166.31	$700.06
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.81 / $58.70 / $60.30	Professional	26	$40.81	$58.70	$60.30
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $85.39 / $107.60 / $113.57	Professional	TC	$85.39	$107.60	$113.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.57 / $281.70 / $281.70	Professional		$127.57	$281.70	$281.70
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.26 / $99.44 / $99.44	Professional	26	$46.26	$99.44	$99.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $81.31 / $182.27 / $182.27	Professional	TC	$81.31	$182.27	$182.27
United Facility/Professional Professional Modifier Low / Median / High Price $115.81 / $175.37 / $427.60	Professional		$115.81	$175.37	$427.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $61.43 / $150.94	Professional	26	$16.22	$61.43	$150.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.01 / $137.76 / $276.66	Professional	TC	$61.01	$137.76	$276.66