Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.64 / $226.36 / $488.73	Facility	26	$54.64	$226.36	$488.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.75 / $163.85 / $189.91	Professional		$155.75	$163.85	$189.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $54.64 / $64.75	Professional	26	$53.70	$54.64	$64.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.06 / $109.21 / $119.91	Professional	TC	$102.06	$109.21	$119.91
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $297.74 / $389.66 / $810.52	Professional		$297.74	$389.66	$810.52
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $61.74 / $67.73 / $73.84	Professional	26	$61.74	$67.73	$73.84
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $228.85 / $320.57 / $350.89	Professional	TC	$228.85	$320.57	$350.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.13 / $407.21 / $978.93	Professional		$285.13	$407.21	$978.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.28 / $71.23 / $165.23	Professional	26	$56.28	$71.23	$165.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.02 / $319.69 / $813.70	Professional	TC	$221.02	$319.69	$813.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $304.32 / $366.36 / $781.37	Professional		$304.32	$366.36	$781.37
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.54 / $67.80 / $129.75	Professional	26	$58.54	$67.80	$129.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $245.78 / $298.55 / $651.62	Professional	TC	$245.78	$298.55	$651.62
United Facility/Professional Professional Modifier Low / Median / High Price $254.40 / $571.95 / $940.02	Professional		$254.40	$571.95	$940.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.44 / $71.91 / $162.04	Professional	26	$46.44	$71.91	$162.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $210.41 / $428.41 / $783.93	Professional	TC	$210.41	$428.41	$783.93