Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.37 / $245.83 / $503.11	Facility	26	$56.37	$245.83	$503.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.53 / $221.92 / $362.37	Professional		$215.53	$221.92	$362.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.37 / $56.37 / $93.71	Professional	26	$56.37	$56.37	$93.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.75 / $165.55 / $268.64	Professional	TC	$152.75	$165.55	$268.64
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $215.09 / $255.19 / $621.02	Professional		$215.09	$255.19	$621.02
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $65.55 / $68.34 / $169.50	Professional	26	$65.55	$68.34	$169.50
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $150.01 / $178.35 / $323.39	Professional	TC	$150.01	$178.35	$323.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.11 / $321.49 / $884.79	Professional		$223.11	$321.49	$884.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.12 / $89.25 / $241.28	Professional	26	$61.12	$89.25	$241.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $160.83 / $213.68 / $631.28	Professional	TC	$160.83	$213.68	$631.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $222.99 / $267.26 / $518.72	Professional		$222.99	$267.26	$518.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.63 / $70.06 / $133.24	Professional	26	$60.63	$70.06	$133.24
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $162.37 / $197.20 / $385.48	Professional	TC	$162.37	$197.20	$385.48
United Facility/Professional Professional Modifier Low / Median / High Price $191.96 / $259.45 / $579.74	Professional		$191.96	$259.45	$579.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.52 / $119.71 / $145.54	Professional	26	$55.52	$119.71	$145.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $135.24 / $287.97 / $434.20	Professional	TC	$135.24	$287.97	$434.20