Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.32 / $95.24 / $198.31	Facility	26	$22.32	$95.24	$198.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.26 / $160.91 / $230.01	Professional		$149.26	$160.91	$230.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.97 / $22.32 / $22.32	Professional	26	$21.97	$22.32	$22.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $127.29 / $138.59 / $138.59	Professional	TC	$127.29	$138.59	$138.59
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $166.88 / $208.77 / $596.76	Professional		$166.88	$208.77	$596.76
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $24.80 / $24.80 / $27.03	Professional	26	$24.80	$24.80	$27.03
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $141.43 / $183.98 / $200.54	Professional	TC	$141.43	$183.98	$200.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.91 / $231.19 / $493.55	Professional		$159.91	$231.19	$493.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.76 / $29.91 / $68.64	Professional	26	$22.76	$29.91	$68.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.26 / $204.77 / $424.91	Professional	TC	$138.26	$204.77	$424.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.99 / $199.84 / $382.43	Professional		$165.99	$199.84	$382.43
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.84 / $27.25 / $51.79	Professional	26	$23.84	$27.25	$51.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $142.13 / $172.59 / $330.64	Professional	TC	$142.13	$172.59	$330.64
United Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $219.21 / $475.46	Professional		$145.49	$219.21	$475.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.80 / $30.26 / $65.98	Professional	26	$19.80	$30.26	$65.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.44 / $236.54 / $409.48	Professional	TC	$131.44	$236.54	$409.48