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 / $644.13	Facility	26	$118.59	$286.98	$644.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $400.00 / $550.00	Professional		$400.00	$400.00	$550.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.00 / $118.59 / $161.00	Professional	26	$110.00	$118.59	$161.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $281.41 / $440.00	Professional	TC	$281.41	$281.41	$440.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $468.98 / $482.53 / $1,776.84	Professional		$468.98	$482.53	$1,776.84
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $87.30 / $97.00 / $154.52	Professional	26	$87.30	$97.00	$154.52
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $349.99 / $388.88 / $641.65	Professional	TC	$349.99	$388.88	$641.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $381.55 / $699.79 / $1,281.36	Professional		$381.55	$699.79	$1,281.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.86 / $120.05 / $255.12	Professional	26	$68.86	$120.05	$255.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $280.11 / $566.49 / $978.14	Professional	TC	$280.11	$566.49	$978.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $292.00 / $651.83 / $651.83	Professional		$292.00	$651.83	$651.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.78 / $179.24 / $179.24	Professional	26	$81.78	$179.24	$179.24
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $210.23 / $472.58 / $472.58	Professional	TC	$210.23	$472.58	$472.58
United Facility/Professional Professional Modifier Low / Median / High Price $268.11 / $523.83 / $1,039.29	Professional		$268.11	$523.83	$1,039.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.83 / $117.41 / $276.13	Professional	26	$66.83	$117.41	$276.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $221.42 / $347.85 / $844.37	Professional	TC	$221.42	$347.85	$844.37