Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.34 / $122.57 / $204.26	Facility	26	$23.34	$122.57	$204.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.26 / $132.55 / $316.66	Professional		$95.26	$132.55	$316.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.34 / $23.34 / $56.48	Professional	26	$23.34	$23.34	$56.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.98 / $109.21 / $254.45	Professional	TC	$65.98	$109.21	$254.45
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $150.59 / $199.30 / $549.67	Professional		$150.59	$199.30	$549.67
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $30.05 / $30.05 / $32.75	Professional	26	$30.05	$30.05	$32.75
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $118.95 / $169.25 / $184.48	Professional	TC	$118.95	$169.25	$184.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.10 / $235.51 / $550.75	Professional		$160.10	$235.51	$550.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.04 / $37.92 / $72.45	Professional	26	$27.04	$37.92	$72.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $129.47 / $203.66 / $471.69	Professional	TC	$129.47	$203.66	$471.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $167.50 / $201.30 / $381.68	Professional		$167.50	$201.30	$381.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.89 / $41.42 / $54.25	Professional	26	$35.89	$41.42	$54.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $131.61 / $159.87 / $327.43	Professional	TC	$131.61	$159.87	$327.43
United Facility/Professional Professional Modifier Low / Median / High Price $159.44 / $430.17 / $483.34	Professional		$159.44	$430.17	$483.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.53 / $40.27 / $71.22	Professional	26	$23.53	$40.27	$71.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $124.72 / $183.10 / $414.64	Professional	TC	$124.72	$183.10	$414.64