Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.27 / $55.39 / $198.31	Facility	26	$21.27	$55.39	$198.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.68 / $125.64 / $304.04	Professional		$116.68	$125.64	$304.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $21.27 / $34.72	Professional	26	$14.49	$21.27	$34.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.80 / $104.37 / $172.15	Professional	TC	$95.80	$104.37	$172.15
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $122.33 / $127.54 / $432.85	Professional		$122.33	$127.54	$432.85
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.62 / $21.51 / $25.09	Professional	26	$15.62	$21.51	$25.09
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $106.03 / $111.02 / $119.81	Professional	TC	$106.03	$111.02	$119.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.17 / $188.28 / $417.74	Professional		$123.17	$188.28	$417.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.77 / $25.06 / $66.42	Professional	26	$16.77	$25.06	$66.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.81 / $155.69 / $353.48	Professional	TC	$102.81	$155.69	$353.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.13 / $152.78 / $294.56	Professional		$127.13	$152.78	$294.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.07 / $26.40 / $51.00	Professional	26	$23.07	$26.40	$51.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $104.06 / $126.37 / $243.54	Professional	TC	$104.06	$126.37	$243.54
United Facility/Professional Professional Modifier Low / Median / High Price $118.23 / $224.48 / $373.13	Professional		$118.23	$224.48	$373.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.92 / $26.82 / $64.58	Professional	26	$12.92	$26.82	$64.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.68 / $194.40 / $354.13	Professional	TC	$103.68	$194.40	$354.13