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 / $691.83	Facility	26	$117.49	$288.40	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $478.63 / $1,348.96	Professional		$354.81	$478.63	$1,348.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $208.93 / $380.19	Professional	26	$112.20	$208.93	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $338.84 / $812.83	Professional	TC	$223.87	$338.84	$812.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $478.63 / $3,890.45	Professional		$245.47	$478.63	$3,890.45
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $147.91 / $162.18	Professional	26	$125.89	$147.91	$162.18
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $302.00 / $1,737.80	Professional	TC	$288.40	$302.00	$1,737.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $812.83 / $1,380.38	Professional		$323.59	$812.83	$1,380.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $141.25 / $309.03	Professional	26	$93.33	$141.25	$309.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $602.56 / $1,122.02	Professional	TC	$229.09	$602.56	$1,122.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $407.38 / $776.25	Professional		$338.84	$407.38	$776.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $125.89 / $239.88	Professional	26	$109.65	$125.89	$239.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $275.42 / $549.54	Professional	TC	$229.09	$275.42	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $630.96 / $1,202.26	Professional		$338.84	$630.96	$1,202.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $138.04 / $371.54	Professional	26	$89.13	$138.04	$371.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $467.74 / $831.76	Professional	TC	$251.19	$467.74	$831.76