Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.85 / $57.53 / $202.70	Facility	26	$22.85	$57.53	$202.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.23 / $108.65 / $240.13	Professional		$99.23	$108.65	$240.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.85 / $25.87 / $55.29	Professional	26	$22.85	$25.87	$55.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.38 / $76.38 / $126.39	Professional	TC	$76.38	$76.38	$126.39
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $103.96 / $107.57 / $297.08	Professional		$103.96	$107.57	$297.08
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $26.57 / $27.06 / $43.06	Professional	26	$26.57	$27.06	$43.06
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $64.51 / $76.91 / $88.47	Professional	TC	$64.51	$76.91	$88.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.47 / $149.94 / $378.41	Professional		$103.47	$149.94	$378.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.67 / $36.17 / $87.14	Professional	26	$24.67	$36.17	$87.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.75 / $108.07 / $291.26	Professional	TC	$78.75	$108.07	$291.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.12 / $121.26 / $233.84	Professional		$101.12	$121.26	$233.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.61 / $28.40 / $54.01	Professional	26	$24.61	$28.40	$54.01
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $76.51 / $92.86 / $179.83	Professional	TC	$76.51	$92.86	$179.83
United Facility/Professional Professional Modifier Low / Median / High Price $83.80 / $133.81 / $283.70	Professional		$83.80	$133.81	$283.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.15 / $36.36 / $58.11	Professional	26	$22.15	$36.36	$58.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.19 / $100.48 / $215.17	Professional	TC	$63.19	$100.48	$215.17