Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.81 / $101.18 / $301.52	Facility	26	$41.81	$101.18	$301.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $151.74 / $180.48	Professional		$140.00	$151.74	$180.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $42.92 / $101.18	Professional	26	$40.29	$42.92	$101.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.72 / $109.93 / $128.15	Professional	TC	$99.72	$109.93	$128.15
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $181.25 / $181.25 / $303.29	Professional		$181.25	$181.25	$303.29
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $47.35 / $52.61 / $57.34	Professional	26	$47.35	$52.61	$57.34
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $115.78 / $128.63 / $140.22	Professional	TC	$115.78	$128.63	$140.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.99 / $240.45 / $653.42	Professional		$142.99	$240.45	$653.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.67 / $69.51 / $179.49	Professional	26	$39.67	$69.51	$179.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $103.32 / $167.57 / $473.94	Professional	TC	$103.32	$167.57	$473.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.79 / $196.60 / $374.67	Professional		$169.79	$196.60	$374.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.10 / $54.54 / $103.71	Professional	26	$47.10	$54.54	$103.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $122.69 / $142.07 / $270.95	Professional	TC	$122.69	$142.07	$270.95
United Facility/Professional Professional Modifier Low / Median / High Price $142.03 / $411.03 / $560.88	Professional		$142.03	$411.03	$560.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.01 / $67.76 / $155.25	Professional	26	$40.01	$67.76	$155.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.19 / $120.54 / $405.63	Professional	TC	$104.19	$120.54	$405.63