Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $229.09 / $398.11	Facility	26	$54.95	$229.09	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $234.42 / $2,398.83	Professional		$173.78	$234.42	$2,398.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $67.61 / $208.93	Professional	26	$44.67	$67.61	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $173.78 / $2,187.76	Professional	TC	$128.82	$173.78	$2,187.76
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $2,041.74 / $2,951.21	Professional		$288.40	$2,041.74	$2,951.21
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $79.43 / $107.15	Professional	26	$45.71	$79.43	$107.15
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $223.87 / $363.08	Professional	TC	$213.80	$223.87	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $575.44 / $1,096.48	Professional		$190.55	$575.44	$1,096.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $61.66 / $275.42	Professional	26	$51.29	$61.66	$275.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $512.86 / $831.76	Professional	TC	$138.04	$512.86	$831.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $478.63 / $524.81	Professional		$245.47	$478.63	$524.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $123.03 / $134.90	Professional	26	$63.10	$123.03	$134.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $354.81 / $389.05	Professional	TC	$181.97	$354.81	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $389.05 / $794.33	Professional		$229.09	$389.05	$794.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $77.62 / $204.17	Professional	26	$23.44	$77.62	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $338.84 / $588.84	Professional	TC	$169.82	$338.84	$588.84