Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $407.38 / $446.68	Professional		$338.84	$407.38	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $112.20 / $134.90	Professional	26	$109.65	$112.20	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $295.12 / $309.03	Professional	TC	$229.09	$295.12	$309.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $724.44 / $1,318.26	Professional		$239.88	$724.44	$1,318.26
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $128.82 / $154.88	Professional	26	$117.49	$128.82	$154.88
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $489.78 / $537.03	Professional	TC	$380.19	$489.78	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $426.58 / $1,148.15	Professional		$323.59	$426.58	$1,148.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $138.04 / $302.00	Professional	26	$107.15	$138.04	$302.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $288.40 / $851.14	Professional	TC	$234.42	$288.40	$851.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $380.19 / $870.96	Professional		$363.08	$380.19	$870.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $114.82 / $234.42	Professional	26	$109.65	$114.82	$234.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $263.03 / $630.96	Professional	TC	$251.19	$263.03	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $426.58 / $954.99	Professional		$302.00	$426.58	$954.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $134.90 / $257.04	Professional	26	$95.50	$134.90	$257.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $302.00 / $691.83	Professional	TC	$208.93	$302.00	$691.83