Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.41 / $166.84 / $455.19	Facility	26	$51.41	$166.84	$455.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.73 / $226.84 / $394.90	Professional		$208.73	$226.84	$394.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.58 / $51.41 / $63.62	Professional	26	$49.58	$51.41	$63.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.15 / $175.43 / $334.58	Professional	TC	$159.15	$175.43	$334.58
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $343.00 / $363.78 / $1,147.76	Professional		$343.00	$363.78	$1,147.76
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $58.28 / $63.79 / $74.30	Professional	26	$58.28	$63.79	$74.30
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $260.52 / $289.48 / $304.33	Professional	TC	$260.52	$289.48	$304.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.47 / $452.94 / $1,218.33	Professional		$302.47	$452.94	$1,218.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.45 / $84.57 / $239.74	Professional	26	$48.45	$84.57	$239.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $237.39 / $385.64 / $978.60	Professional	TC	$237.39	$385.64	$978.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $274.00 / $616.21 / $616.21	Professional		$274.00	$616.21	$616.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $125.86 / $125.86	Professional	26	$57.54	$125.86	$125.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $216.47 / $490.35 / $490.35	Professional	TC	$216.47	$490.35	$490.35
United Facility/Professional Professional Modifier Low / Median / High Price $216.00 / $346.60 / $935.32	Professional		$216.00	$346.60	$935.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.76 / $140.22 / $191.04	Professional	26	$50.76	$140.22	$191.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.24 / $292.73 / $744.28	Professional	TC	$165.24	$292.73	$744.28