Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $234.42 / $389.05	Facility	26	$53.70	$234.42	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $134.90 / $407.38	Professional		$102.33	$134.90	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $338.84 / $977.24	Professional	26	$60.26	$338.84	$977.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $70.79 / $338.84	Professional	TC	$51.29	$70.79	$338.84
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $562.34 / $724.44	Professional		$131.83	$562.34	$724.44
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $70.79 / $162.18	Professional	26	$60.26	$70.79	$162.18
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $83.18 / $251.19	Professional	TC	$70.79	$83.18	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $162.18 / $575.44	Professional		$112.20	$162.18	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $61.66 / $263.03	Professional	26	$52.48	$61.66	$263.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $104.71 / $309.03	Professional	TC	$61.66	$104.71	$309.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $158.49 / $295.12	Professional		$138.04	$158.49	$295.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $74.13 / $134.90	Professional	26	$63.10	$74.13	$134.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $87.10 / $158.49	Professional	TC	$74.13	$87.10	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $154.88 / $416.87	Professional		$125.89	$154.88	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $74.13 / $190.55	Professional	26	$46.77	$74.13	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $95.50 / $223.87	Professional	TC	$74.13	$95.50	$223.87