Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $173.78 / $363.08	Facility	26	$51.29	$173.78	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $275.42 / $537.03	Professional		$213.80	$275.42	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $61.66 / $141.25	Professional	26	$51.29	$61.66	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $208.93 / $416.87	Professional	TC	$162.18	$208.93	$416.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $346.74 / $1,513.56	Professional		$263.03	$346.74	$1,513.56
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $67.61 / $74.13	Professional	26	$58.88	$67.61	$74.13
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $288.40 / $316.23	Professional	TC	$251.19	$288.40	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $398.11 / $758.58	Professional		$223.87	$398.11	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $69.18 / $162.18	Professional	26	$48.98	$69.18	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $338.84 / $630.96	Professional	TC	$173.78	$338.84	$630.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $316.23 / $616.60	Professional		$269.15	$316.23	$616.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $67.61 / $125.89	Professional	26	$57.54	$67.61	$125.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $251.19 / $489.78	Professional	TC	$208.93	$251.19	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $389.05 / $933.25	Professional		$234.42	$389.05	$933.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $72.44 / $190.55	Professional	26	$41.69	$72.44	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $302.00 / $741.31	Professional	TC	$181.97	$302.00	$741.31