Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.87 / $167.78 / $422.09	Facility	26	$58.87	$167.78	$422.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.94 / $234.30 / $410.67	Professional		$215.94	$234.30	$410.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.79 / $58.87 / $138.33	Professional	26	$56.79	$58.87	$138.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.15 / $175.43 / $346.55	Professional	TC	$159.15	$175.43	$346.55
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $369.22 / $376.61 / $1,172.67	Professional		$369.22	$376.61	$1,172.67
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $73.45 / $80.06 / $121.19	Professional	26	$73.45	$80.06	$121.19
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $266.19 / $295.77 / $488.02	Professional	TC	$266.19	$295.77	$488.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $304.01 / $462.52 / $1,259.33	Professional		$304.01	$462.52	$1,259.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.53 / $97.20 / $276.08	Professional	26	$55.53	$97.20	$276.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.14 / $385.64 / $983.26	Professional	TC	$229.14	$385.64	$983.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $273.08 / $327.84 / $637.94	Professional		$273.08	$327.84	$637.94
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $65.94 / $76.34 / $145.18	Professional	26	$65.94	$76.34	$145.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $206.93 / $251.49 / $492.77	Professional	TC	$206.93	$251.49	$492.77
United Facility/Professional Professional Modifier Low / Median / High Price $221.50 / $405.76 / $968.31	Professional		$221.50	$405.76	$968.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.98 / $95.00 / $220.36	Professional	26	$53.98	$95.00	$220.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $179.76 / $518.74 / $747.95	Professional	TC	$179.76	$518.74	$747.95