Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.14 / $140.03 / $354.54	Facility	26	$49.14	$140.03	$354.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.55 / $165.99 / $165.99	Professional		$153.55	$165.99	$165.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.38 / $49.14 / $49.14	Professional	26	$47.38	$49.14	$49.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.17 / $116.85 / $116.85	Professional	TC	$106.17	$116.85	$116.85
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $181.56 / $241.47 / $835.64	Professional		$181.56	$241.47	$835.64
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $61.03 / $61.03 / $66.52	Professional	26	$61.03	$61.03	$66.52
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $120.53 / $132.80 / $160.30	Professional	TC	$120.53	$132.80	$160.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.27 / $390.87 / $835.59	Professional		$158.27	$390.87	$835.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.95 / $93.47 / $247.71	Professional	26	$46.95	$93.47	$247.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.33 / $292.89 / $587.88	Professional	TC	$111.33	$292.89	$587.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $187.95 / $412.23 / $412.23	Professional		$187.95	$412.23	$412.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $55.75 / $121.94 / $121.94	Professional	26	$55.75	$121.94	$121.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $132.19 / $290.27 / $290.27	Professional	TC	$132.19	$290.27	$290.27
United Facility/Professional Professional Modifier Low / Median / High Price $157.66 / $197.70 / $616.66	Professional		$157.66	$197.70	$616.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.80 / $79.42 / $182.42	Professional	26	$45.80	$79.42	$182.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.24 / $179.37 / $434.24	Professional	TC	$110.24	$179.37	$434.24