Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.25 / $141.66 / $495.88	Facility	26	$56.25	$141.66	$495.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.18 / $104.29 / $196.06	Professional		$93.18	$104.29	$196.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.25 / $60.45 / $84.40	Professional	26	$56.25	$60.45	$84.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.51 / $48.04 / $65.95	Professional	TC	$30.51	$48.04	$65.95
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $99.16 / $110.17 / $301.06	Professional		$99.16	$110.17	$301.06
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $61.57 / $61.57 / $76.95	Professional	26	$61.57	$61.57	$76.95
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.59 / $48.61 / $60.76	Professional	TC	$28.59	$48.61	$60.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.40 / $199.89 / $448.89	Professional		$100.40	$199.89	$448.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.14 / $109.94 / $253.22	Professional	26	$63.14	$109.94	$253.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.13 / $68.56 / $195.67	Professional	TC	$33.13	$68.56	$195.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.19 / $114.80 / $241.75	Professional		$97.19	$114.80	$241.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $55.37 / $63.14 / $131.27	Professional	26	$55.37	$63.14	$131.27
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $41.82 / $51.66 / $110.48	Professional	TC	$41.82	$51.66	$110.48
United Facility/Professional Professional Modifier Low / Median / High Price $75.52 / $119.38 / $290.83	Professional		$75.52	$119.38	$290.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.33 / $82.45 / $166.24	Professional	26	$57.33	$82.45	$166.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.13 / $47.25 / $139.90	Professional	TC	$28.13	$47.25	$139.90