Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $131.83 / $245.47	Facility	26	$56.23	$131.83	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $123.03 / $281.84	Professional		$85.11	$123.03	$281.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $70.79 / $169.82	Professional	26	$53.70	$70.79	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $44.67 / $79.43	Professional	TC	$28.18	$44.67	$79.43
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $102.33 / $380.19	Professional		$63.10	$102.33	$380.19
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $56.23 / $70.79	Professional	26	$54.95	$56.23	$70.79
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $51.29 / $69.18	Professional	TC	$25.70	$51.29	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $204.17 / $446.68	Professional		$104.71	$204.17	$446.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $112.20 / $251.19	Professional	26	$64.57	$112.20	$251.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $75.86 / $194.98	Professional	TC	$36.31	$75.86	$194.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $117.49 / $239.88	Professional		$100.00	$117.49	$239.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $64.57 / $131.83	Professional	26	$56.23	$64.57	$131.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $53.70 / $109.65	Professional	TC	$43.65	$53.70	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $120.23 / $275.42	Professional		$85.11	$120.23	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $81.28 / $165.96	Professional	26	$53.70	$81.28	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.02 / $104.71	Professional	TC	$28.18	$38.02	$104.71