Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $53.70 / $478.63	Facility	26	$53.70	$53.70	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $190.55 / $426.58	Professional		$107.15	$190.55	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $64.57 / $141.25	Professional	26	$52.48	$64.57	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $61.66 / $144.54	Professional	TC	$52.48	$61.66	$144.54
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $128.82 / $741.31	Professional		$56.23	$128.82	$741.31
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $61.66 / $67.61	Professional	26	$56.23	$61.66	$67.61
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $67.61 / $165.96	Professional	TC	$60.26	$67.61	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $177.83 / $346.74	Professional		$114.82	$177.83	$346.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $70.79 / $141.25	Professional	26	$54.95	$70.79	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $95.50 / $199.53	Professional	TC	$57.54	$95.50	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $138.04 / $269.15	Professional		$128.82	$138.04	$269.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $64.57 / $131.83	Professional	26	$61.66	$64.57	$131.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $72.44 / $141.25	Professional	TC	$66.07	$72.44	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $169.82 / $346.74	Professional		$114.82	$169.82	$346.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $69.18 / $165.96	Professional	26	$50.12	$69.18	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $104.71 / $177.83	Professional	TC	$57.54	$104.71	$177.83