Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.49 / $90.39 / $318.32	Facility	26	$35.49	$90.39	$318.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.78 / $194.47 / $524.40	Professional		$190.78	$194.47	$524.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.30 / $35.49 / $85.88	Professional	26	$28.30	$35.49	$85.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $145.97 / $158.97 / $384.73	Professional	TC	$145.97	$158.97	$384.73
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $198.74 / $202.32 / $696.97	Professional		$198.74	$202.32	$696.97
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $31.59 / $35.10 / $77.63	Professional	26	$31.59	$35.10	$77.63
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $167.21 / $167.21 / $321.41	Professional	TC	$167.21	$167.21	$321.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.12 / $287.08 / $619.52	Professional		$189.12	$287.08	$619.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.51 / $44.79 / $108.39	Professional	26	$31.51	$44.79	$108.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.44 / $232.19 / $538.42	Professional	TC	$154.44	$232.19	$538.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $195.14 / $234.44 / $452.26	Professional		$195.14	$234.44	$452.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.00 / $43.60 / $82.91	Professional	26	$38.00	$43.60	$82.91
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $157.13 / $190.83 / $369.34	Professional	TC	$157.13	$190.83	$369.34
United Facility/Professional Professional Modifier Low / Median / High Price $177.19 / $266.98 / $572.71	Professional		$177.19	$266.98	$572.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.36 / $47.70 / $105.00	Professional	26	$25.36	$47.70	$105.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $142.69 / $266.35 / $467.71	Professional	TC	$142.69	$266.35	$467.71