Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $511.58 / $1,117.00 / $3,175.00	Facility		$511.58	$1,117.00	$3,175.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.70 / $92.16 / $97.16	Facility	26	$41.70	$92.16	$97.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.87 / $221.87 / $536.91	Professional		$221.87	$221.87	$536.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.70 / $41.70 / $100.09	Professional	26	$41.70	$41.70	$100.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $180.17 / $180.17 / $436.01	Professional	TC	$180.17	$180.17	$436.01
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $232.39 / $260.76 / $898.94	Professional		$232.39	$260.76	$898.94
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $44.91 / $46.98 / $82.86	Professional	26	$44.91	$46.98	$82.86
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $187.48 / $193.35 / $233.02	Professional	TC	$187.48	$193.35	$233.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.40 / $209.06 / $734.09	Professional		$132.40	$209.06	$734.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.90 / $71.34 / $132.25	Professional	26	$39.90	$71.34	$132.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.63 / $157.18 / $601.84	Professional	TC	$85.63	$157.18	$601.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $179.05 / $449.88 / $449.88	Professional		$179.05	$449.88	$449.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.47 / $86.94 / $86.94	Professional	26	$39.47	$86.94	$86.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $139.56 / $362.94 / $362.94	Professional	TC	$139.56	$362.94	$362.94
United Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $442.00 / $5,940.00	Facility		$165.00	$442.00	$5,940.00
United Facility/Professional Professional Modifier Low / Median / High Price $151.72 / $212.38 / $521.26	Professional		$151.72	$212.38	$521.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.04 / $84.92 / $100.74	Professional	26	$37.04	$84.92	$100.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.62 / $163.38 / $420.52	Professional	TC	$102.62	$163.38	$420.52