Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $39.81 / $354.81	Facility	26	$39.81	$39.81	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $151.36 / $295.12	Professional		$120.23	$151.36	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $51.29 / $158.49	Professional	26	$38.02	$51.29	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $104.71 / $223.87	Professional	TC	$77.62	$104.71	$223.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $165.96 / $812.83	Professional		$138.04	$165.96	$812.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $45.71 / $123.03	Professional	26	$40.74	$45.71	$123.03
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $107.15 / $269.15	Professional	TC	$95.50	$107.15	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $190.55 / $331.13	Professional		$138.04	$190.55	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $56.23 / $117.49	Professional	26	$42.66	$56.23	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $141.25 / $257.04	Professional	TC	$93.33	$141.25	$257.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $158.49 / $323.59	Professional		$147.91	$158.49	$323.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $46.77 / $93.33	Professional	26	$44.67	$46.77	$93.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $112.20 / $229.09	Professional	TC	$102.33	$112.20	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $323.59	Professional		$128.82	$169.82	$323.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $53.70 / $100.00	Professional	26	$38.90	$53.70	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $131.83 / $229.09	Professional	TC	$87.10	$131.83	$229.09