Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $58.88 / $144.54	Facility	26	$19.95	$58.88	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $218.78 / $371.54	Professional		$162.18	$218.78	$371.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $31.62 / $63.10	Professional	26	$16.98	$31.62	$63.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $181.97 / $346.74	Professional	TC	$147.91	$181.97	$346.74
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $630.96 / $933.25	Professional		$218.78	$630.96	$933.25
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $23.99 / $32.36	Professional	26	$21.88	$23.99	$32.36
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $218.78 / $295.12	Professional	TC	$199.53	$218.78	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $389.05 / $1,122.02	Professional		$194.98	$389.05	$1,122.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $34.67 / $102.33	Professional	26	$19.50	$34.67	$102.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $354.81 / $1,023.29	Professional	TC	$177.83	$354.81	$1,023.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $269.15 / $524.81	Professional		$234.42	$269.15	$524.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $26.92 / $50.12	Professional	26	$23.44	$26.92	$50.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $245.47 / $478.63	Professional	TC	$208.93	$245.47	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $302.00 / $776.25	Professional		$218.78	$302.00	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $28.84 / $75.86	Professional	26	$19.05	$28.84	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $269.15 / $707.95	Professional	TC	$199.53	$269.15	$707.95