Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $218.78 / $549.54	Facility	26	$75.86	$218.78	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $309.03 / $645.65	Professional		$245.47	$309.03	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $91.20 / $275.42	Professional	26	$54.95	$91.20	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $218.78 / $707.95	Professional	TC	$169.82	$218.78	$707.95
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $398.11 / $1,995.26	Professional		$89.13	$398.11	$1,995.26
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $109.65 / $120.23	Professional	26	$100.00	$109.65	$120.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $288.40 / $436.52	Professional	TC	$263.03	$288.40	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $501.19 / $1,000.00	Professional		$288.40	$501.19	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $107.15 / $245.47	Professional	26	$72.44	$107.15	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $398.11 / $776.25	Professional	TC	$218.78	$398.11	$776.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $354.81 / $676.08	Professional		$302.00	$354.81	$676.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $100.00 / $190.55	Professional	26	$87.10	$100.00	$190.55
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $257.04 / $489.78	Professional	TC	$213.80	$257.04	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $436.52 / $1,023.29	Professional		$263.03	$436.52	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $109.65 / $288.40	Professional	26	$64.57	$109.65	$288.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $316.23 / $741.31	Professional	TC	$194.98	$316.23	$741.31