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 $223.87 / $426.58 / $812.83	Professional		$223.87	$426.58	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $213.80 / $489.78	Professional	26	$107.15	$213.80	$489.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $363.08 / $933.25	Professional	TC	$281.84	$363.08	$933.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $575.44 / $3,801.89	Professional		$125.89	$575.44	$3,801.89
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $138.04 / $141.25	Professional	26	$112.20	$138.04	$141.25
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $426.58 / $776.25	Professional	TC	$389.05	$426.58	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $870.96 / $1,380.38	Professional		$407.38	$870.96	$1,380.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $120.23 / $288.40	Professional	26	$87.10	$120.23	$288.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $724.44 / $1,202.26	Professional	TC	$316.23	$724.44	$1,202.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $436.52 / $954.99	Professional		$407.38	$436.52	$954.99
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $107.15 / $223.87	Professional	26	$102.33	$107.15	$223.87
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $331.13 / $758.58	Professional	TC	$302.00	$331.13	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $660.69 / $1,445.44	Professional		$398.11	$660.69	$1,445.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $128.82 / $346.74	Professional	26	$72.44	$128.82	$346.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $549.54 / $1,096.48	Professional	TC	$316.23	$549.54	$1,096.48