Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $162.18 / $478.63	Facility	26	$67.61	$162.18	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $234.42 / $478.63	Professional		$194.98	$234.42	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $89.13 / $199.53	Professional	26	$64.57	$89.13	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $158.49 / $338.84	Professional	TC	$128.82	$158.49	$338.84
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $288.40 / $3,548.13	Professional		$93.33	$288.40	$3,548.13
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $102.33 / $138.04	Professional	26	$87.10	$102.33	$138.04
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $218.78 / $239.88	Professional	TC	$194.98	$218.78	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $309.03 / $660.69	Professional		$218.78	$309.03	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $93.33 / $213.80	Professional	26	$64.57	$93.33	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $213.80 / $436.52	Professional	TC	$151.36	$213.80	$436.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $275.42 / $537.03	Professional		$229.09	$275.42	$537.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $87.10 / $165.96	Professional	26	$75.86	$87.10	$165.96
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $186.21 / $371.54	Professional	TC	$154.88	$186.21	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $602.56 / $1,047.13	Professional		$239.88	$602.56	$1,047.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $95.50 / $257.04	Professional	26	$51.29	$95.50	$257.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $416.87 / $691.83	Professional	TC	$169.82	$416.87	$691.83