Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.87 / $130.62 / $453.76	Facility	26	$51.87	$130.62	$453.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.62 / $96.79 / $172.90	Professional		$83.62	$96.79	$172.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.87 / $55.70 / $84.77	Professional	26	$51.87	$55.70	$84.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.89 / $44.93 / $61.79	Professional	TC	$26.89	$44.93	$61.79
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $91.94 / $102.16 / $284.52	Professional		$91.94	$102.16	$284.52
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $56.63 / $56.63 / $70.79	Professional	26	$56.63	$56.63	$70.79
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $25.11 / $45.53 / $56.91	Professional	TC	$25.11	$45.53	$56.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.09 / $185.21 / $418.84	Professional		$92.09	$185.21	$418.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.18 / $101.30 / $233.08	Professional	26	$58.18	$101.30	$233.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.00 / $63.82 / $182.72	Professional	TC	$31.00	$63.82	$182.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.02 / $106.37 / $224.13	Professional		$90.02	$106.37	$224.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.01 / $58.18 / $120.90	Professional	26	$51.01	$58.18	$120.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $39.02 / $48.19 / $103.22	Professional	TC	$39.02	$48.19	$103.22
United Facility/Professional Professional Modifier Low / Median / High Price $74.15 / $114.11 / $269.63	Professional		$74.15	$114.11	$269.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.28 / $74.22 / $156.68	Professional	26	$46.28	$74.22	$156.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.51 / $46.99 / $130.71	Professional	TC	$26.51	$46.99	$130.71