Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.17 / $208.55 / $623.79	Facility	26	$73.17	$208.55	$623.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.46 / $223.93 / $300.00	Professional		$207.46	$223.93	$300.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.56 / $73.17 / $177.07	Professional	26	$70.56	$73.17	$177.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.90 / $150.75 / $220.36	Professional	TC	$136.90	$150.75	$220.36
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $323.76 / $329.98 / $996.06	Professional		$323.76	$329.98	$996.06
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $90.10 / $90.10 / $106.19	Professional	26	$90.10	$90.10	$106.19
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $215.89 / $239.88 / $261.47	Professional	TC	$215.89	$239.88	$261.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $265.11 / $413.67 / $1,054.23	Professional		$265.11	$413.67	$1,054.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.11 / $120.06 / $341.07	Professional	26	$69.11	$120.06	$341.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $175.06 / $285.68 / $713.16	Professional	TC	$175.06	$285.68	$713.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.46 / $285.86 / $548.41	Professional		$239.46	$285.86	$548.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $82.06 / $95.02 / $179.87	Professional	26	$82.06	$95.02	$179.87
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $157.13 / $190.83 / $368.55	Professional	TC	$157.13	$190.83	$368.55
United Facility/Professional Professional Modifier Low / Median / High Price $209.31 / $357.89 / $832.43	Professional		$209.31	$357.89	$832.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.54 / $95.36 / $273.02	Professional	26	$64.54	$95.36	$273.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.58 / $273.83 / $559.40	Professional	TC	$139.58	$273.83	$559.40