Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.11 / $174.67 / $355.63	Facility	26	$40.11	$174.67	$355.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.22 / $137.22 / $226.62	Professional		$137.22	$137.22	$226.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.11 / $40.11 / $66.62	Professional	26	$40.11	$40.11	$66.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.11 / $97.11 / $159.99	Professional	TC	$97.11	$97.11	$159.99
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $131.91 / $158.11 / $569.85	Professional		$131.91	$158.11	$569.85
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $46.23 / $48.68 / $121.19	Professional	26	$46.23	$48.68	$121.19
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $88.11 / $106.71 / $290.01	Professional	TC	$88.11	$106.71	$290.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.30 / $222.75 / $523.29	Professional		$132.30	$222.75	$523.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.43 / $63.44 / $152.97	Professional	26	$43.43	$63.44	$152.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.39 / $143.44 / $370.33	Professional	TC	$91.39	$143.44	$370.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.87 / $167.31 / $321.39	Professional		$139.87	$167.31	$321.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $43.13 / $49.84 / $93.97	Professional	26	$43.13	$49.84	$93.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $96.74 / $117.47 / $227.42	Professional	TC	$96.74	$117.47	$227.42
United Facility/Professional Professional Modifier Low / Median / High Price $129.60 / $214.04 / $403.39	Professional		$129.60	$214.04	$403.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.71 / $56.00 / $103.55	Professional	26	$36.71	$56.00	$103.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.03 / $131.80 / $229.58	Professional	TC	$88.03	$131.80	$229.58