Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.11 / $176.92 / $198.42	Facility	26	$73.11	$176.92	$198.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.92 / $133.78 / $210.41	Professional		$125.92	$133.78	$210.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.04 / $73.11 / $111.62	Professional	26	$72.04	$73.11	$111.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.87 / $61.31 / $98.80	Professional	TC	$53.87	$61.31	$98.80
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $118.69 / $131.88 / $269.83	Professional		$118.69	$131.88	$269.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $65.05 / $72.28 / $119.26	Professional	26	$65.05	$72.28	$119.26
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $53.64 / $59.60 / $98.34	Professional	TC	$53.64	$59.60	$98.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.29 / $345.92 / $574.05	Professional		$147.29	$345.92	$574.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.33 / $188.37 / $332.35	Professional	26	$83.33	$188.37	$332.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.97 / $153.85 / $241.71	Professional	TC	$63.97	$153.85	$241.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.15 / $310.41 / $310.41	Professional		$139.15	$310.41	$310.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $78.72 / $173.33 / $173.33	Professional	26	$78.72	$173.33	$173.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $60.43 / $137.11 / $137.11	Professional	TC	$60.43	$137.11	$137.11
United Facility/Professional Professional Modifier Low / Median / High Price $136.26 / $290.89 / $393.09	Professional		$136.26	$290.89	$393.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.05 / $98.03 / $219.49	Professional	26	$66.05	$98.03	$219.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.03 / $85.64 / $190.12	Professional	TC	$52.03	$85.64	$190.12