Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.08 / $235.08 / $455.19	Facility	26	$51.08	$235.08	$455.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.49 / $194.58 / $393.43	Professional		$179.49	$194.58	$393.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.28 / $51.08 / $60.00	Professional	26	$49.28	$51.08	$60.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $130.21 / $143.50 / $337.38	Professional	TC	$130.21	$143.50	$337.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $279.50 / $303.07 / $1,025.31	Professional		$279.50	$303.07	$1,025.31
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $63.79 / $74.30 / $86.37	Professional	26	$63.79	$74.30	$86.37
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $201.45 / $223.84 / $292.06	Professional	TC	$201.45	$223.84	$292.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.95 / $404.99 / $917.04	Professional		$276.95	$404.99	$917.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.14 / $84.11 / $239.74	Professional	26	$48.14	$84.11	$239.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $337.69 / $677.30	Professional	TC	$199.53	$337.69	$677.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $205.36 / $246.02 / $473.46	Professional		$205.36	$246.02	$473.46
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.17 / $66.20 / $125.86	Professional	26	$57.17	$66.20	$125.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $148.00 / $179.82 / $347.59	Professional	TC	$148.00	$179.82	$347.59
United Facility/Professional Professional Modifier Low / Median / High Price $201.24 / $416.40 / $723.69	Professional		$201.24	$416.40	$723.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.18 / $82.01 / $191.05	Professional	26	$47.18	$82.01	$191.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $149.61 / $299.93 / $587.24	Professional	TC	$149.61	$299.93	$587.24