Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.17 / $211.37 / $527.65	Facility	26	$74.17	$211.37	$527.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.50 / $249.27 / $431.44	Professional		$230.50	$249.27	$431.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.58 / $74.17 / $172.80	Professional	26	$71.58	$74.17	$172.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.91 / $175.10 / $351.12	Professional	TC	$158.91	$175.10	$351.12
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $386.46 / $404.91 / $1,467.96	Professional		$386.46	$404.91	$1,467.96
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $83.70 / $91.20 / $107.14	Professional	26	$83.70	$91.20	$107.14
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $282.33 / $313.70 / $370.89	Professional	TC	$282.33	$313.70	$370.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $375.45 / $588.44 / $1,291.93	Professional		$375.45	$588.44	$1,291.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.72 / $121.03 / $342.70	Professional	26	$69.72	$121.03	$342.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $273.57 / $504.04 / $1,088.97	Professional	TC	$273.57	$504.04	$1,088.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $300.70 / $667.78 / $667.78	Professional		$300.70	$667.78	$667.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $82.79 / $181.48 / $181.48	Professional	26	$82.79	$181.48	$181.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $217.92 / $486.30 / $486.30	Professional	TC	$217.92	$486.30	$486.30
United Facility/Professional Professional Modifier Low / Median / High Price $270.89 / $483.80 / $1,143.23	Professional		$270.89	$483.80	$1,143.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $81.78 / $275.45	Professional	26	$67.61	$81.78	$275.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $206.61 / $309.91 / $942.23	Professional	TC	$206.61	$309.91	$942.23