Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $286.98 / $648.21	Facility	26	$118.59	$286.98	$648.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $425.00 / $544.60	Professional		$400.00	$425.00	$544.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $113.20 / $120.93 / $213.20	Professional	26	$113.20	$120.93	$213.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $299.00 / $386.94	Professional	TC	$281.41	$299.00	$386.94
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $592.95 / $608.92 / $3,134.63	Professional		$592.95	$608.92	$3,134.63
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $103.26 / $115.41 / $125.80	Professional	26	$103.26	$115.41	$125.80
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $444.16 / $493.52 / $814.31	Professional	TC	$444.16	$493.52	$814.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $479.43 / $1,069.81 / $1,800.82	Professional		$479.43	$1,069.81	$1,800.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.19 / $147.80 / $313.42	Professional	26	$86.19	$147.80	$313.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $344.40 / $792.61 / $1,405.19	Professional	TC	$344.40	$792.61	$1,405.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $368.62 / $822.98 / $822.98	Professional		$368.62	$822.98	$822.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $102.34 / $222.95 / $222.95	Professional	26	$102.34	$222.95	$222.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $266.27 / $600.03 / $600.03	Professional	TC	$266.27	$600.03	$600.03
United Facility/Professional Professional Modifier Low / Median / High Price $353.08 / $563.79 / $1,267.81	Professional		$353.08	$563.79	$1,267.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.00 / $115.06 / $343.45	Professional	26	$73.00	$115.06	$343.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $279.58 / $502.31 / $924.36	Professional	TC	$279.58	$502.31	$924.36