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 / $645.65	Facility	26	$117.49	$288.40	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $457.09 / $812.83	Professional		$234.42	$457.09	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $165.96 / $457.09	Professional	26	$107.15	$165.96	$457.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $380.19 / $933.25	Professional	TC	$281.84	$380.19	$933.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $660.69 / $3,981.07	Professional		$549.54	$660.69	$3,981.07
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $128.82 / $186.21	Professional	26	$112.20	$128.82	$186.21
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $467.74 / $1,548.82	Professional	TC	$426.58	$467.74	$1,548.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $891.25 / $1,412.54	Professional		$426.58	$891.25	$1,412.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $123.03 / $288.40	Professional	26	$87.10	$123.03	$288.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $758.58 / $1,258.93	Professional	TC	$338.84	$758.58	$1,258.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $512.86 / $1,023.29	Professional		$436.52	$512.86	$1,023.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $120.23 / $223.87	Professional	26	$102.33	$120.23	$223.87
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $398.11 / $812.83	Professional	TC	$331.13	$398.11	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $691.83 / $1,548.82	Professional		$416.87	$691.83	$1,548.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $128.82 / $346.74	Professional	26	$74.13	$128.82	$346.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $588.84 / $1,202.26	Professional	TC	$338.84	$588.84	$1,202.26