Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.50 / $101.16 / $253.66	Facility	26	$35.50	$101.16	$253.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.16 / $267.87 / $648.24	Professional		$245.16	$267.87	$648.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.26 / $35.50 / $85.90	Professional	26	$34.26	$35.50	$85.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $210.89 / $232.37 / $562.33	Professional	TC	$210.89	$232.37	$562.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $290.45 / $386.30 / $887.29	Professional		$290.45	$386.30	$887.29
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $43.66 / $43.66 / $58.07	Professional	26	$43.66	$43.66	$58.07
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $246.78 / $246.78 / $328.22	Professional	TC	$246.78	$246.78	$328.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $241.24 / $350.69 / $1,379.79	Professional		$241.24	$350.69	$1,379.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.68 / $66.55 / $176.12	Professional	26	$33.68	$66.55	$176.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $207.57 / $284.14 / $1,203.67	Professional	TC	$207.57	$284.14	$1,203.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $286.47 / $643.72 / $643.72	Professional		$286.47	$643.72	$643.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.00 / $87.24 / $87.24	Professional	26	$40.00	$87.24	$87.24
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $246.49 / $556.45 / $556.45	Professional	TC	$246.49	$556.45	$556.45
United Facility/Professional Professional Modifier Low / Median / High Price $203.12 / $339.26 / $962.93	Professional		$203.12	$339.26	$962.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.72 / $46.05 / $130.51	Professional	26	$32.72	$46.05	$130.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $170.25 / $293.20 / $832.42	Professional	TC	$170.25	$293.20	$832.42