Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.24 / $41.24 / $41.24	Facility	26	$41.24	$41.24	$41.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.06 / $140.96 / $200.60	Professional		$116.06	$140.96	$200.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.51 / $42.92 / $63.44	Professional	26	$40.51	$42.92	$63.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.55 / $93.95 / $153.26	Professional	TC	$75.55	$93.95	$153.26
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $130.22 / $144.69 / $238.75	Professional		$130.22	$144.69	$238.75
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $36.28 / $40.31 / $43.94	Professional	26	$36.28	$40.31	$43.94
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $93.95 / $104.39 / $117.75	Professional	TC	$93.95	$104.39	$117.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.63 / $326.31 / $613.66	Professional		$131.63	$326.31	$613.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.81 / $109.28 / $185.60	Professional	26	$46.81	$109.28	$185.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.73 / $219.11 / $391.30	Professional	TC	$81.73	$219.11	$391.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.53 / $286.89 / $286.89	Professional		$125.53	$286.89	$286.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.22 / $97.37 / $97.37	Professional	26	$44.22	$97.37	$97.37
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $81.31 / $189.53 / $189.53	Professional	TC	$81.31	$189.53	$189.53
United Facility/Professional Professional Modifier Low / Median / High Price $86.32 / $199.85 / $367.18	Professional		$86.32	$199.85	$367.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.59 / $91.24 / $123.81	Professional	26	$37.59	$91.24	$123.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.64 / $177.61 / $298.08	Professional	TC	$66.64	$177.61	$298.08