Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.93 / $110.93 / $110.93	Facility	26	$110.93	$110.93	$110.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $418.13 / $418.13 / $418.13	Professional		$418.13	$418.13	$418.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.93 / $110.93 / $110.93	Professional	26	$110.93	$110.93	$110.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $307.20 / $307.20 / $307.20	Professional	TC	$307.20	$307.20	$307.20
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $447.29 / $480.56 / $968.84	Professional		$447.29	$480.56	$968.84
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $120.26 / $124.81 / $255.87	Professional	26	$120.26	$124.81	$255.87
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $327.02 / $355.74 / $521.76	Professional	TC	$327.02	$355.74	$521.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $348.82 / $443.12 / $1,352.90	Professional		$348.82	$443.12	$1,352.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.85 / $153.66 / $351.39	Professional	26	$106.85	$153.66	$351.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $235.89 / $292.19 / $1,001.51	Professional	TC	$235.89	$292.19	$1,001.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $365.06 / $865.91 / $865.91	Professional		$365.06	$865.91	$865.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $105.74 / $232.81 / $232.81	Professional	26	$105.74	$232.81	$232.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $259.32 / $633.10 / $633.10	Professional	TC	$259.32	$633.10	$633.10
United Facility/Professional Professional Modifier Low / Median / High Price $309.54 / $700.91 / $1,003.30	Professional		$309.54	$700.91	$1,003.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.44 / $256.26 / $295.32	Professional	26	$98.44	$256.26	$295.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.93 / $467.06 / $733.55	Professional	TC	$223.93	$467.06	$733.55