Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.23 / $107.34 / $378.21	Facility	26	$42.23	$107.34	$378.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.63 / $275.51 / $436.57	Professional		$206.63	$275.51	$436.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.10 / $42.23 / $70.01	Professional	26	$42.10	$42.23	$70.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.49 / $233.28 / $366.55	Professional	TC	$162.49	$233.28	$366.55
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $226.40 / $276.23 / $864.51	Professional		$226.40	$276.23	$864.51
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $45.54 / $45.54 / $49.64	Professional	26	$45.54	$45.54	$49.64
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $177.55 / $230.70 / $251.46	Professional	TC	$177.55	$230.70	$251.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.56 / $409.34 / $933.10	Professional		$250.56	$409.34	$933.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.95 / $58.13 / $128.72	Professional	26	$43.95	$58.13	$128.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $205.57 / $344.02 / $790.06	Professional	TC	$205.57	$344.02	$790.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $266.63 / $321.33 / $655.34	Professional		$266.63	$321.33	$655.34
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.34 / $52.48 / $101.29	Professional	26	$45.34	$52.48	$101.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $221.30 / $268.87 / $554.04	Professional	TC	$221.30	$268.87	$554.04
United Facility/Professional Professional Modifier Low / Median / High Price $250.10 / $447.32 / $829.89	Professional		$250.10	$447.32	$829.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.51 / $59.57 / $127.88	Professional	26	$38.51	$59.57	$127.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $200.87 / $383.14 / $701.62	Professional	TC	$200.87	$383.14	$701.62