Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.15 / $35.15 / $35.15	Facility	26	$35.15	$35.15	$35.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $253.58 / $253.58 / $417.48	Professional		$253.58	$253.58	$417.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.15 / $35.15 / $36.52	Professional	26	$35.15	$35.15	$36.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.42 / $218.42 / $236.99	Professional	TC	$218.42	$218.42	$236.99
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $261.67 / $261.67 / $556.97	Professional		$261.67	$261.67	$556.97
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $34.95 / $34.95 / $40.35	Professional	26	$34.95	$34.95	$40.35
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $226.72 / $226.72 / $250.74	Professional	TC	$226.72	$226.72	$250.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.43 / $338.90 / $785.96	Professional		$247.43	$338.90	$785.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.36 / $46.73 / $106.43	Professional	26	$36.36	$46.73	$106.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.13 / $293.45 / $679.53	Professional	TC	$213.13	$293.45	$679.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.11 / $309.02 / $591.70	Professional		$257.11	$309.02	$591.70
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.86 / $43.98 / $82.02	Professional	26	$38.86	$43.98	$82.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $218.23 / $265.05 / $509.68	Professional	TC	$218.23	$265.05	$509.68
United Facility/Professional Professional Modifier Low / Median / High Price $228.96 / $347.98 / $749.30	Professional		$228.96	$347.98	$749.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.57 / $46.66 / $103.54	Professional	26	$31.57	$46.66	$103.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $197.24 / $301.32 / $645.42	Professional	TC	$197.24	$301.32	$645.42