Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $275.42 / $537.03	Facility	26	$117.49	$275.42	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $426.58 / $870.96	Professional		$281.84	$426.58	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $141.25 / $407.38	Professional	26	$89.13	$141.25	$407.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $302.00 / $660.69	Professional	TC	$194.98	$302.00	$660.69
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $398.11 / $2,511.89	Professional		$114.82	$398.11	$2,511.89
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $104.71 / $125.89	Professional	26	$85.11	$104.71	$125.89
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $288.40 / $467.74	Professional	TC	$257.04	$288.40	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $602.56 / $1,174.90	Professional		$275.42	$602.56	$1,174.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $102.33 / $239.88	Professional	26	$72.44	$102.33	$239.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $501.19 / $933.25	Professional	TC	$199.53	$501.19	$933.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $338.84 / $660.69	Professional		$288.40	$338.84	$660.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $97.72 / $186.21	Professional	26	$85.11	$97.72	$186.21
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $245.47 / $478.63	Professional	TC	$199.53	$245.47	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $524.81 / $1,023.29	Professional		$275.42	$524.81	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $107.15 / $288.40	Professional	26	$61.66	$107.15	$288.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $389.05 / $724.44	Professional	TC	$218.78	$389.05	$724.44