Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.27 / $275.99 / $1,115.20	Facility		$102.27	$275.99	$1,115.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.73 / $39.11 / $99.05	Facility	26	$13.73	$39.11	$99.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.35 / $102.27 / $169.44	Professional		$91.35	$102.27	$169.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.22 / $13.73 / $18.00	Professional	26	$13.22	$13.73	$18.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.31 / $88.54 / $105.33	Professional	TC	$76.31	$88.54	$105.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $95.84 / $110.49 / $230.12	Professional		$95.84	$110.49	$230.12
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.35 / $17.05 / $18.60	Professional	26	$15.35	$17.05	$18.60
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $78.78 / $93.43 / $101.84	Professional	TC	$78.78	$93.43	$101.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $401.46 / $626.85 / $1,959.63	Facility		$401.46	$626.85	$1,959.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.52 / $118.77 / $444.41	Professional		$84.52	$118.77	$444.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.03 / $22.85 / $57.02	Professional	26	$13.03	$22.85	$57.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.27 / $94.31 / $387.40	Professional	TC	$68.27	$94.31	$387.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.97 / $127.34 / $248.60	Professional		$109.97	$127.34	$248.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.48 / $17.92 / $34.07	Professional	26	$15.48	$17.92	$34.07
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $94.50 / $109.42 / $214.53	Professional	TC	$94.50	$109.42	$214.53
United Facility/Professional Professional Modifier Low / Median / High Price $74.89 / $118.73 / $315.01	Professional		$74.89	$118.73	$315.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.60 / $21.89 / $43.17	Professional	26	$13.60	$21.89	$43.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.64 / $120.59 / $271.83	Professional	TC	$61.64	$120.59	$271.83