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 / $682.78	Facility	26	$118.59	$286.98	$682.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $425.00 / $597.36	Professional		$400.00	$425.00	$597.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.59 / $126.00 / $223.28	Professional	26	$118.59	$126.00	$223.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $299.00 / $469.10	Professional	TC	$281.41	$299.00	$469.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $714.05 / $783.47 / $3,134.97	Professional		$714.05	$783.47	$3,134.97
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $108.31 / $121.56 / $132.50	Professional	26	$108.31	$121.56	$132.50
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $586.96 / $661.91 / $859.43	Professional	TC	$586.96	$661.91	$859.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $641.49 / $1,235.04 / $2,286.75	Professional		$641.49	$1,235.04	$2,286.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.73 / $156.05 / $331.38	Professional	26	$90.73	$156.05	$331.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $525.00 / $1,084.05 / $1,845.37	Professional	TC	$525.00	$1,084.05	$1,845.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $513.20 / $1,152.61 / $1,152.61	Professional		$513.20	$1,152.61	$1,152.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $107.74 / $234.84 / $234.84	Professional	26	$107.74	$234.84	$234.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $405.46 / $917.78 / $917.78	Professional	TC	$405.46	$917.78	$917.78
United Facility/Professional Professional Modifier Low / Median / High Price $477.94 / $672.75 / $1,775.62	Professional		$477.94	$672.75	$1,775.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.97 / $120.72 / $361.77	Professional	26	$76.97	$120.72	$361.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $382.53 / $688.27 / $1,413.85	Professional	TC	$382.53	$688.27	$1,413.85