Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.53 / $237.65 / $483.64	Facility	26	$54.53	$237.65	$483.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.97 / $113.97 / $309.35	Professional		$113.97	$113.97	$309.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.53 / $54.53 / $91.76	Professional	26	$54.53	$54.53	$91.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.55 / $59.44 / $143.84	Professional	TC	$54.55	$59.44	$143.84
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $133.61 / $142.04 / $465.83	Professional		$133.61	$142.04	$465.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $61.77 / $65.67 / $71.58	Professional	26	$61.77	$65.67	$71.58
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $69.43 / $76.37 / $165.93	Professional	TC	$69.43	$76.37	$165.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.55 / $213.19 / $385.99	Professional		$114.55	$213.19	$385.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.86 / $75.06 / $163.53	Professional	26	$57.86	$75.06	$163.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.02 / $115.76 / $201.89	Professional	TC	$59.02	$115.76	$201.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.07 / $142.40 / $271.58	Professional		$120.07	$142.40	$271.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.32 / $68.61 / $130.46	Professional	26	$59.32	$68.61	$130.46
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $60.75 / $73.79 / $141.13	Professional	TC	$60.75	$73.79	$141.13
United Facility/Professional Professional Modifier Low / Median / High Price $115.86 / $194.08 / $343.93	Professional		$115.86	$194.08	$343.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.62 / $73.70 / $164.62	Professional	26	$48.62	$73.70	$164.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.12 / $104.27 / $178.62	Professional	TC	$54.12	$104.27	$178.62