Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $288.40 / $724.44	Facility	26	$100.00	$288.40	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $251.19 / $346.74	Professional		$204.17	$251.19	$346.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $117.49 / $218.78	Professional	26	$87.10	$117.49	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $123.03 / $218.78	Professional	TC	$97.72	$123.03	$218.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $588.84 / $977.24	Professional		$131.83	$588.84	$977.24
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $147.91 / $147.91	Professional	26	$125.89	$147.91	$147.91
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $407.38 / $489.78	Professional	TC	$389.05	$407.38	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $575.44 / $1,318.26	Professional		$407.38	$575.44	$1,318.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $128.82 / $316.23	Professional	26	$95.50	$128.82	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $436.52 / $1,047.13	Professional	TC	$295.12	$436.52	$1,047.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $467.74 / $1,000.00	Professional		$436.52	$467.74	$1,000.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $120.23 / $251.19	Professional	26	$114.82	$120.23	$251.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $354.81 / $776.25	Professional	TC	$323.59	$354.81	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $562.34 / $1,513.56	Professional		$281.84	$562.34	$1,513.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $134.90 / $380.19	Professional	26	$75.86	$134.90	$380.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $416.87 / $1,148.15	Professional	TC	$204.17	$416.87	$1,148.15