Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.04 / $106.52 / $309.63	Facility	26	$35.04	$106.52	$309.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.96 / $162.47 / $393.20	Professional		$136.96	$162.47	$393.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.44 / $46.71 / $136.63	Professional	26	$33.44	$46.71	$136.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $103.52 / $127.44 / $308.39	Professional	TC	$103.52	$127.44	$308.39
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $82.76 / $177.38 / $235.92	Professional		$82.76	$177.38	$235.92
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $22.07 / $48.39 / $48.39	Professional	26	$22.07	$48.39	$48.39
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $9.69 / $128.99 / $128.99	Professional	TC	$9.69	$128.99	$128.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.27 / $134.25 / $749.10	Professional		$81.27	$134.25	$749.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.78 / $54.58 / $161.55	Professional	26	$19.78	$54.58	$161.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.52 / $80.61 / $587.54	Professional	TC	$62.52	$80.61	$587.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $227.01 / $420.99 / $420.99	Professional		$227.01	$420.99	$420.99
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $50.55 / $91.96 / $91.96	Professional	26	$50.55	$91.96	$91.96
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $176.46 / $329.03 / $329.03	Professional	TC	$176.46	$329.03	$329.03
United Facility/Professional Professional Modifier Low / Median / High Price $110.44 / $131.61 / $444.44	Professional		$110.44	$131.61	$444.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.32 / $41.31 / $122.41	Professional	26	$30.32	$41.31	$122.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.38 / $101.29 / $347.36	Professional	TC	$76.38	$101.29	$347.36