Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.35 / $263.57 / $854.44	Facility	26	$100.35	$263.57	$854.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.69 / $275.45 / $372.31	Professional		$255.69	$275.45	$372.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.78 / $100.35 / $242.84	Professional	26	$96.78	$100.35	$242.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.91 / $175.10 / $266.22	Professional	TC	$158.91	$175.10	$266.22
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $388.56 / $423.53 / $1,337.13	Professional		$388.56	$423.53	$1,337.13
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $119.61 / $123.84 / $145.97	Professional	26	$119.61	$123.84	$145.97
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $268.94 / $281.24 / $312.31	Professional	TC	$268.94	$281.24	$312.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.83 / $689.44 / $1,507.00	Professional		$436.83	$689.44	$1,507.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.49 / $163.36 / $464.58	Professional	26	$95.49	$163.36	$464.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $303.74 / $559.77 / $1,042.42	Professional	TC	$303.74	$559.77	$1,042.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $339.81 / $405.68 / $776.31	Professional		$339.81	$405.68	$776.31
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $113.39 / $131.30 / $247.28	Professional	26	$113.39	$131.30	$247.28
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $225.90 / $274.37 / $529.03	Professional	TC	$225.90	$274.37	$529.03
United Facility/Professional Professional Modifier Low / Median / High Price $287.61 / $433.89 / $1,178.33	Professional		$287.61	$433.89	$1,178.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.87 / $159.47 / $375.34	Professional	26	$88.87	$159.47	$375.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.06 / $358.60 / $802.99	Professional	TC	$239.06	$358.60	$802.99