Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $286.98 / $644.13	Facility	26	$118.59	$286.98	$644.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $400.00 / $546.25	Professional		$400.00	$400.00	$546.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.59 / $118.59 / $140.00	Professional	26	$118.59	$118.59	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $281.41 / $385.24	Professional	TC	$281.41	$281.41	$385.24
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $535.65 / $551.16 / $1,776.84	Professional		$535.65	$551.16	$1,776.84
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $83.45 / $93.65 / $102.08	Professional	26	$83.45	$93.65	$102.08
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $411.76 / $457.52 / $539.97	Professional	TC	$411.76	$457.52	$539.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $430.13 / $699.70 / $1,447.55	Professional		$430.13	$699.70	$1,447.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.86 / $120.05 / $255.12	Professional	26	$68.86	$120.05	$255.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $319.88 / $605.10 / $1,107.50	Professional	TC	$319.88	$605.10	$1,107.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $318.02 / $381.37 / $736.51	Professional		$318.02	$381.37	$736.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.78 / $94.69 / $179.24	Professional	26	$81.78	$94.69	$179.24
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $235.94 / $286.68 / $557.29	Professional	TC	$235.94	$286.68	$557.29
United Facility/Professional Professional Modifier Low / Median / High Price $279.49 / $498.83 / $1,145.23	Professional		$279.49	$498.83	$1,145.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.60 / $95.51 / $276.13	Professional	26	$58.60	$95.51	$276.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $249.55 / $496.53 / $940.89	Professional	TC	$249.55	$496.53	$940.89