Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.83 / $153.41 / $385.69	Facility	26	$53.83	$153.41	$385.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.79 / $228.93 / $339.97	Professional		$210.79	$228.93	$339.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.94 / $53.83 / $126.05	Professional	26	$51.94	$53.83	$126.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.85 / $175.10 / $281.72	Professional	TC	$158.85	$175.10	$281.72
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $307.16 / $334.93 / $966.14	Professional		$307.16	$334.93	$966.14
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $66.39 / $72.37 / $103.92	Professional	26	$66.39	$72.37	$103.92
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $230.96 / $256.62 / $397.29	Professional	TC	$230.96	$256.62	$397.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.05 / $386.88 / $1,123.94	Professional		$263.05	$386.88	$1,123.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.74 / $87.96 / $251.02	Professional	26	$50.74	$87.96	$251.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.95 / $311.41 / $872.91	Professional	TC	$194.95	$311.41	$872.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $243.00 / $291.57 / $567.35	Professional		$243.00	$291.57	$567.35
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.25 / $69.76 / $132.65	Professional	26	$60.25	$69.76	$132.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $182.52 / $221.80 / $434.69	Professional	TC	$182.52	$221.80	$434.69
United Facility/Professional Professional Modifier Low / Median / High Price $196.75 / $306.75 / $861.15	Professional		$196.75	$306.75	$861.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.45 / $68.81 / $201.35	Professional	26	$43.45	$68.81	$201.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $143.62 / $272.33 / $659.80	Professional	TC	$143.62	$272.33	$659.80