Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.23 / $295.12 / $331.13	Facility	26	$120.23	$295.12	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $245.47 / $645.65	Professional		$199.53	$245.47	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $141.25 / $323.59	Professional	26	$120.23	$141.25	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $93.33 / $169.82	Professional	TC	$77.62	$93.33	$169.82
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $186.21 / $323.59	Professional		$79.43	$186.21	$323.59
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $107.15 / $128.82	Professional	26	$107.15	$107.15	$128.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $89.13 / $251.19	Professional	TC	$89.13	$89.13	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $338.84 / $891.25	Professional		$257.04	$338.84	$891.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $199.53 / $549.54	Professional	26	$147.91	$199.53	$549.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $141.25 / $346.74	Professional	TC	$102.33	$141.25	$346.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $275.42 / $489.78	Professional		$234.42	$275.42	$489.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $162.18 / $288.40	Professional	26	$138.04	$162.18	$288.40
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $112.20 / $213.80	Professional	TC	$97.72	$112.20	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $380.19 / $616.60	Professional		$213.80	$380.19	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $245.47 / $363.08	Professional	26	$112.20	$245.47	$363.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $186.21 / $251.19	Professional	TC	$95.50	$186.21	$251.19