Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.00 / $232.91 / $460.75	Facility	26	$54.00	$232.91	$460.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.61 / $117.86 / $151.90	Professional		$109.61	$117.86	$151.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.67 / $65.12 / $489.29	Professional	26	$53.67	$65.12	$489.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.94 / $63.85 / $94.98	Professional	TC	$57.94	$63.85	$94.98
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $148.55 / $148.55 / $673.38	Professional		$148.55	$148.55	$673.38
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $68.12 / $68.12 / $157.27	Professional	26	$68.12	$68.12	$157.27
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $80.43 / $80.43 / $270.77	Professional	TC	$80.43	$80.43	$270.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.94 / $311.45 / $575.49	Professional		$126.94	$311.45	$575.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.86 / $94.91 / $263.89	Professional	26	$52.86	$94.91	$263.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.90 / $216.54 / $311.60	Professional	TC	$65.90	$216.54	$311.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.38 / $293.45 / $293.45	Professional		$134.38	$293.45	$293.45
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.86 / $134.59 / $134.59	Professional	26	$61.86	$134.59	$134.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $72.52 / $158.88 / $158.88	Professional	TC	$72.52	$158.88	$158.88
United Facility/Professional Professional Modifier Low / Median / High Price $128.87 / $182.47 / $416.06	Professional		$128.87	$182.47	$416.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.26 / $145.33 / $190.81	Professional	26	$47.26	$145.33	$190.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.41 / $85.41 / $225.25	Professional	TC	$69.41	$85.41	$225.25