Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $257.85 / $407.02	Facility	26	$118.59	$257.85	$407.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $425.00 / $475.00	Professional		$400.00	$425.00	$475.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.59 / $126.00 / $140.00	Professional	26	$118.59	$126.00	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $299.00 / $335.00	Professional	TC	$281.41	$299.00	$335.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $398.88 / $409.17 / $1,463.69	Professional		$398.88	$409.17	$1,463.69
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $68.18 / $75.76 / $120.30	Professional	26	$68.18	$75.76	$120.30
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $302.63 / $336.26 / $554.83	Professional	TC	$302.63	$336.26	$554.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.72 / $576.48 / $1,078.69	Professional		$321.72	$576.48	$1,078.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.54 / $93.34 / $264.73	Professional	26	$53.54	$93.34	$264.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $242.30 / $492.56 / $861.43	Professional	TC	$242.30	$492.56	$861.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.98 / $550.50 / $550.50	Professional		$245.98	$550.50	$550.50
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.58 / $139.99 / $139.99	Professional	26	$63.58	$139.99	$139.99
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $182.40 / $410.50 / $410.50	Professional	TC	$182.40	$410.50	$410.50
United Facility/Professional Professional Modifier Low / Median / High Price $252.18 / $400.49 / $848.04	Professional		$252.18	$400.49	$848.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.69 / $75.47 / $215.66	Professional	26	$45.69	$75.47	$215.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $191.80 / $287.70 / $735.83	Professional	TC	$191.80	$287.70	$735.83