Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.21 / $87.98 / $303.45	Facility	26	$34.21	$87.98	$303.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.28 / $78.80 / $133.63	Professional		$61.28	$78.80	$133.63
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $93.81 / $93.81 / $93.81	Professional	25	$93.81	$93.81	$93.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.21 / $37.40 / $51.77	Professional	26	$34.21	$37.40	$51.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $44.58 / $61.27	Professional	TC	$22.57	$44.58	$61.27
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $82.95 / $92.17 / $214.03	Professional		$82.95	$92.17	$214.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $46.98 / $46.98 / $92.38	Professional	26	$46.98	$46.98	$92.38
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.89 / $45.18 / $56.48	Professional	TC	$26.89	$45.18	$56.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.38 / $130.52 / $336.66	Professional		$72.38	$130.52	$336.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.26 / $66.62 / $155.38	Professional	26	$38.26	$66.62	$155.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.46 / $56.11 / $181.28	Professional	TC	$26.46	$56.11	$181.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.30 / $86.07 / $182.46	Professional		$72.30	$86.07	$182.46
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.60 / $38.26 / $80.05	Professional	26	$33.60	$38.26	$80.05
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.70 / $47.80 / $102.41	Professional	TC	$38.70	$47.80	$102.41
United Facility/Professional Professional Modifier Low / Median / High Price $56.48 / $94.75 / $219.50	Professional		$56.48	$94.75	$219.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.50 / $50.36 / $103.69	Professional	26	$31.50	$50.36	$103.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.60 / $43.50 / $123.20	Professional	TC	$20.60	$43.50	$123.20