Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.13 / $235.05 / $263.63	Facility	26	$97.13	$235.05	$263.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.61 / $175.99 / $414.88	Professional		$164.61	$175.99	$414.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.18 / $97.13 / $182.60	Professional	26	$96.18	$97.13	$182.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.43 / $79.70 / $139.68	Professional	TC	$68.43	$79.70	$139.68
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $156.02 / $173.36 / $286.04	Professional		$156.02	$173.36	$286.04
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $86.84 / $96.49 / $159.21	Professional	26	$86.84	$96.49	$159.21
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $69.19 / $76.87 / $126.84	Professional	TC	$69.19	$76.87	$126.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.39 / $451.62 / $749.58	Professional		$192.39	$451.62	$749.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.97 / $252.03 / $441.69	Professional	26	$110.97	$252.03	$441.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.42 / $196.88 / $307.89	Professional	TC	$81.42	$196.88	$307.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $181.75 / $405.02 / $405.02	Professional		$181.75	$405.02	$405.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $104.83 / $230.83 / $230.83	Professional	26	$104.83	$230.83	$230.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $76.91 / $174.20 / $174.20	Professional	TC	$76.91	$174.20	$174.20
United Facility/Professional Professional Modifier Low / Median / High Price $155.34 / $379.54 / $537.08	Professional		$155.34	$379.54	$537.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.95 / $141.52 / $292.67	Professional	26	$79.95	$141.52	$292.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.13 / $111.56 / $244.41	Professional	TC	$67.13	$111.56	$244.41