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 / $693.72	Facility	26	$118.59	$286.98	$693.72
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 / $251.61	Professional	26	$118.59	$126.00	$251.61
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 $523.69 / $534.78 / $3,203.64	Professional		$523.69	$534.78	$3,203.64
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $111.84 / $129.12 / $164.29	Professional	26	$111.84	$129.12	$164.29
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $394.58 / $411.25 / $678.56	Professional	TC	$394.58	$411.25	$678.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $429.67 / $1,002.77 / $1,773.67	Professional		$429.67	$1,002.77	$1,773.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.17 / $158.44 / $335.35	Professional	26	$92.17	$158.44	$335.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $306.16 / $789.49 / $1,246.08	Professional	TC	$306.16	$789.49	$1,246.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $346.42 / $773.28 / $773.28	Professional		$346.42	$773.28	$773.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $109.45 / $238.60 / $238.60	Professional	26	$109.45	$238.60	$238.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $236.97 / $534.70 / $534.70	Professional	TC	$236.97	$534.70	$534.70
United Facility/Professional Professional Modifier Low / Median / High Price $292.74 / $529.49 / $1,191.24	Professional		$292.74	$529.49	$1,191.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.19 / $123.56 / $367.56	Professional	26	$81.19	$123.56	$367.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $249.61 / $426.50 / $823.68	Professional	TC	$249.61	$426.50	$823.68