Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $288.40 / $676.08	Facility	26	$117.49	$288.40	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $575.44 / $1,202.26	Professional		$398.11	$575.44	$1,202.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $169.82 / $467.74	Professional	26	$112.20	$169.82	$467.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $416.87 / $977.24	Professional	TC	$281.84	$416.87	$977.24
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $707.95 / $3,981.07	Professional		$501.19	$707.95	$3,981.07
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $131.83 / $147.91	Professional	26	$97.72	$131.83	$147.91
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $549.54 / $776.25	Professional	TC	$489.78	$549.54	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $954.99 / $1,659.59	Professional		$501.19	$954.99	$1,659.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $128.82 / $302.00	Professional	26	$91.20	$128.82	$302.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $851.14 / $1,412.54	Professional	TC	$407.38	$851.14	$1,412.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $588.84 / $1,174.90	Professional		$501.19	$588.84	$1,174.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $123.03 / $234.42	Professional	26	$107.15	$123.03	$234.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $467.74 / $977.24	Professional	TC	$389.05	$467.74	$977.24
United Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $812.83 / $1,778.28	Professional		$478.63	$812.83	$1,778.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $134.90 / $363.08	Professional	26	$77.62	$134.90	$363.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $676.08 / $1,412.54	Professional	TC	$389.05	$676.08	$1,412.54