Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.35 / $1,793.00 / $4,100.00	Facility		$1,000.35	$1,793.00	$4,100.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.59 / $290.95 / $306.60	Facility	26	$131.59	$290.95	$306.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $439.96 / $439.96 / $1,055.89	Professional		$439.96	$439.96	$1,055.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.59 / $131.59 / $315.80	Professional	26	$131.59	$131.59	$315.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $308.37 / $308.37 / $740.08	Professional	TC	$308.37	$308.37	$740.08
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $467.45 / $509.89 / $974.73	Professional		$467.45	$509.89	$974.73
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $142.09 / $148.30 / $302.00	Professional	26	$142.09	$148.30	$302.00
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $325.36 / $361.58 / $545.32	Professional	TC	$325.36	$361.58	$545.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $373.66 / $474.35 / $1,435.46	Professional		$373.66	$474.35	$1,435.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $127.33 / $179.76 / $417.51	Professional	26	$127.33	$179.76	$417.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.58 / $294.58 / $1,017.94	Professional	TC	$245.58	$294.58	$1,017.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $383.49 / $904.94 / $904.94	Professional		$383.49	$904.94	$904.94
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $126.01 / $275.06 / $275.06	Professional	26	$126.01	$275.06	$275.06
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $257.48 / $629.87 / $629.87	Professional	TC	$257.48	$629.87	$629.87
United Facility/Professional Facility Modifier Low / Median / High Price $665.00 / $762.00 / $6,342.00	Facility		$665.00	$762.00	$6,342.00
United Facility/Professional Professional Modifier Low / Median / High Price $334.14 / $568.92 / $1,048.52	Professional		$334.14	$568.92	$1,048.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $116.96 / $275.05 / $318.70	Professional	26	$116.96	$275.05	$318.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $215.50 / $386.18 / $729.81	Professional	TC	$215.50	$386.18	$729.81