Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.16 / $179.78 / $248.82	Facility	26	$77.16	$179.78	$248.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.64 / $305.57 / $365.54	Professional		$281.64	$305.57	$365.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.45 / $77.16 / $186.72	Professional	26	$74.45	$77.16	$186.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $207.19 / $228.41 / $270.86	Professional	TC	$207.19	$228.41	$270.86
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $434.80 / $437.42 / $2,772.00	Professional		$434.80	$437.42	$2,772.00
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $96.80 / $96.80 / $111.52	Professional	26	$96.80	$96.80	$111.52
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $306.56 / $340.62 / $371.28	Professional	TC	$306.56	$340.62	$371.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.87 / $502.67 / $1,454.81	Professional		$354.87	$502.67	$1,454.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.16 / $126.34 / $358.18	Professional	26	$73.16	$126.34	$358.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.43 / $369.79 / $1,096.63	Professional	TC	$257.43	$369.79	$1,096.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $317.93 / $380.93 / $736.51	Professional		$317.93	$380.93	$736.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $86.88 / $100.60 / $188.90	Professional	26	$86.88	$100.60	$188.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $230.64 / $280.33 / $547.61	Professional	TC	$230.64	$280.33	$547.61
United Facility/Professional Professional Modifier Low / Median / High Price $260.47 / $473.72 / $1,117.91	Professional		$260.47	$473.72	$1,117.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.31 / $98.50 / $286.72	Professional	26	$68.31	$98.50	$286.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $201.70 / $350.11 / $831.19	Professional	TC	$201.70	$350.11	$831.19