Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.07 / $711.42 / $982.43	Facility		$112.07	$711.42	$982.43
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.07 / $97.08 / $243.26	Facility	26	$34.07	$97.08	$243.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.07 / $116.84 / $250.59	Professional		$112.07	$116.84	$250.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.07 / $35.96 / $82.44	Professional	26	$34.07	$35.96	$82.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.00 / $83.81 / $133.91	Professional	TC	$78.00	$83.81	$133.91
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $146.77 / $146.77 / $340.22	Professional		$146.77	$146.77	$340.22
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $42.29 / $42.29 / $103.71	Professional	26	$42.29	$42.29	$103.71
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $94.04 / $104.48 / $164.63	Professional	TC	$94.04	$104.48	$164.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $360.97 / $617.92 / $896.90	Facility		$360.97	$617.92	$896.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.86 / $160.77 / $370.51	Professional		$103.86	$160.77	$370.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.31 / $46.75 / $118.15	Professional	26	$32.31	$46.75	$118.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.29 / $111.64 / $256.88	Professional	TC	$71.29	$111.64	$256.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.82 / $273.99 / $273.99	Professional		$129.82	$273.99	$273.99
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.39 / $83.67 / $83.67	Professional	26	$40.39	$83.67	$83.67
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $89.44 / $190.32 / $190.32	Professional	TC	$89.44	$190.32	$190.32
United Facility/Professional Professional Modifier Low / Median / High Price $106.45 / $125.23 / $377.15	Professional		$106.45	$125.23	$377.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.33 / $37.76 / $115.17	Professional	26	$32.33	$37.76	$115.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.03 / $97.68 / $275.77	Professional	TC	$75.03	$97.68	$275.77