Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.23 / $51.23 / $51.23	Facility	26	$51.23	$51.23	$51.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.56 / $164.25 / $189.85	Professional		$133.56	$164.25	$189.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.18 / $45.03 / $51.23	Professional	26	$43.18	$45.03	$51.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.37 / $107.16 / $127.80	Professional	TC	$90.37	$107.16	$127.80
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $110.27 / $151.88 / $369.23	Professional		$110.27	$151.88	$369.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $34.19 / $37.97 / $62.67	Professional	26	$34.19	$37.97	$62.67
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $76.08 / $92.15 / $139.49	Professional	TC	$76.08	$92.15	$139.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.34 / $155.34 / $378.28	Professional		$115.34	$155.34	$378.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.24 / $56.17 / $117.27	Professional	26	$33.24	$56.17	$117.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.85 / $113.04 / $261.00	Professional	TC	$58.85	$113.04	$261.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.77 / $385.91 / $385.91	Professional		$169.77	$385.91	$385.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $93.14 / $93.14	Professional	26	$42.66	$93.14	$93.14
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $127.10 / $292.77 / $292.77	Professional	TC	$127.10	$292.77	$292.77
United Facility/Professional Professional Modifier Low / Median / High Price $99.60 / $151.26 / $485.25	Professional		$99.60	$151.26	$485.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.36 / $59.88 / $117.12	Professional	26	$34.36	$59.88	$117.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.13 / $91.38 / $368.13	Professional	TC	$59.13	$91.38	$368.13