Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.18 / $239.51 / $252.05	Facility	26	$108.18	$239.51	$252.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.94 / $416.94 / $1,000.64	Professional		$416.94	$416.94	$1,000.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.18 / $108.18 / $261.79	Professional	26	$108.18	$108.18	$261.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $308.76 / $308.76 / $741.02	Professional	TC	$308.76	$308.76	$741.02
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $444.40 / $527.67 / $1,951.00	Professional		$444.40	$527.67	$1,951.00
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $116.96 / $122.08 / $249.47	Professional	26	$116.96	$122.08	$249.47
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $327.45 / $362.03 / $537.16	Professional	TC	$327.45	$362.03	$537.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $347.36 / $442.72 / $1,362.89	Professional		$347.36	$442.72	$1,362.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.29 / $151.56 / $343.69	Professional	26	$104.29	$151.56	$343.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $238.99 / $293.02 / $1,019.21	Professional	TC	$238.99	$293.02	$1,019.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $363.25 / $860.32 / $860.32	Professional		$363.25	$860.32	$860.32
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $103.20 / $226.42 / $226.42	Professional	26	$103.20	$226.42	$226.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $260.05 / $633.91 / $633.91	Professional	TC	$260.05	$633.91	$633.91
United Facility/Professional Professional Modifier Low / Median / High Price $318.14 / $488.77 / $996.82	Professional		$318.14	$488.77	$996.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.27 / $150.43 / $262.35	Professional	26	$96.27	$150.43	$262.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $220.79 / $324.20 / $734.47	Professional	TC	$220.79	$324.20	$734.47