Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.64 / $117.99 / $314.38	Facility	26	$35.64	$117.99	$314.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.89 / $132.40 / $320.39	Professional		$56.89	$132.40	$320.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.15 / $35.64 / $86.24	Professional	26	$34.15	$35.64	$86.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.17 / $96.76 / $234.15	Professional	TC	$18.17	$96.76	$234.15
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $171.17 / $171.17 / $401.62	Professional		$171.17	$171.17	$401.62
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $44.97 / $44.97 / $87.39	Professional	26	$44.97	$44.97	$87.39
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $126.20 / $126.20 / $167.85	Professional	TC	$126.20	$126.20	$167.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $124.13 / $663.13	Professional		$81.79	$124.13	$663.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.96 / $64.20 / $174.23	Professional	26	$35.96	$64.20	$174.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.35 / $89.75 / $488.90	Professional	TC	$23.35	$89.75	$488.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $147.40 / $324.58 / $324.58	Professional		$147.40	$324.58	$324.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.82 / $87.47 / $87.47	Professional	26	$40.82	$87.47	$87.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $106.58 / $237.11 / $237.11	Professional	TC	$106.58	$237.11	$237.11
United Facility/Professional Professional Modifier Low / Median / High Price $46.67 / $460.18 / $460.18	Professional		$46.67	$460.18	$460.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.49 / $99.11 / $124.01	Professional	26	$32.49	$99.11	$124.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.11 / $23.14 / $336.17	Professional	TC	$9.11	$23.14	$336.17