Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $276.31 / $540.12	Facility	26	$118.59	$276.31	$540.12
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 $506.48 / $568.45 / $1,544.68	Professional		$506.48	$568.45	$1,544.68
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $86.90 / $97.00 / $105.73	Professional	26	$86.90	$97.00	$105.73
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $417.25 / $471.45 / $513.88	Professional	TC	$417.25	$471.45	$513.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $454.16 / $650.00 / $1,596.52	Professional		$454.16	$650.00	$1,596.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.36 / $123.94 / $260.77	Professional	26	$71.36	$123.94	$260.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $359.61 / $510.49 / $1,244.32	Professional	TC	$359.61	$510.49	$1,244.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $363.46 / $813.99 / $813.99	Professional		$363.46	$813.99	$813.99
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $84.74 / $185.77 / $185.77	Professional	26	$84.74	$185.77	$185.77
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $278.72 / $628.25 / $628.25	Professional	TC	$278.72	$628.25	$628.25
United Facility/Professional Professional Modifier Low / Median / High Price $304.95 / $509.91 / $1,250.02	Professional		$304.95	$509.91	$1,250.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.98 / $98.46 / $285.27	Professional	26	$69.98	$98.46	$285.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $230.41 / $373.94 / $964.74	Professional	TC	$230.41	$373.94	$964.74