Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.88 / $24.88 / $24.88	Facility	26	$24.88	$24.88	$24.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.30 / $169.00 / $169.00	Professional		$138.30	$169.00	$169.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.16 / $144.12 / $144.12	Professional	TC	$114.16	$144.12	$144.12
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $148.71 / $165.23 / $219.76	Professional		$148.71	$165.23	$219.76
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $127.11 / $141.22 / $153.94	Professional	TC	$127.11	$141.22	$153.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.88 / $394.44 / $772.60	Professional		$107.88	$394.44	$772.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.04 / $381.89 / $657.50	Professional	TC	$61.04	$381.89	$657.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $191.48 / $436.16 / $436.16	Professional		$191.48	$436.16	$436.16
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.05 / $59.56 / $59.56	Professional	26	$27.05	$59.56	$59.56
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $164.44 / $376.60 / $376.60	Professional	TC	$164.44	$376.60	$376.60
United Facility/Professional Professional Modifier Low / Median / High Price $89.91 / $208.96 / $552.33	Professional		$89.91	$208.96	$552.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.41 / $311.33 / $476.91	Professional	TC	$92.41	$311.33	$476.91