Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.32 / $77.83 / $201.71	Facility	26	$22.32	$77.83	$201.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.35 / $126.35 / $207.79	Professional		$126.35	$126.35	$207.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.76 / $22.32 / $41.62	Professional	26	$18.76	$22.32	$41.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.03 / $104.03 / $172.72	Professional	TC	$104.03	$104.03	$172.72
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $134.40 / $159.27 / $442.77	Professional		$134.40	$159.27	$442.77
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.51 / $22.25 / $25.48	Professional	26	$20.51	$22.25	$25.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $113.89 / $137.03 / $167.17	Professional	TC	$113.89	$137.03	$167.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.17 / $187.70 / $427.91	Professional		$124.17	$187.70	$427.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.83 / $29.68 / $68.69	Professional	26	$20.83	$29.68	$68.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.52 / $154.63 / $352.31	Professional	TC	$102.52	$154.63	$352.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.90 / $153.62 / $296.95	Professional		$127.90	$153.62	$296.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.50 / $26.82 / $51.79	Professional	26	$23.50	$26.82	$51.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $104.41 / $126.80 / $245.16	Professional	TC	$104.41	$126.80	$245.16
United Facility/Professional Professional Modifier Low / Median / High Price $118.23 / $239.84 / $373.27	Professional		$118.23	$239.84	$373.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.73 / $39.40 / $65.59	Professional	26	$16.73	$39.40	$65.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.10 / $193.06 / $305.04	Professional	TC	$90.10	$193.06	$305.04