Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.17 / $235.15 / $695.78	Facility	26	$97.17	$235.15	$695.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.05 / $344.35 / $475.00	Professional		$318.05	$344.35	$475.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.73 / $97.17 / $203.70	Professional	26	$93.73	$97.17	$203.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $224.32 / $247.18 / $335.00	Professional	TC	$224.32	$247.18	$335.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $595.46 / $693.59 / $2,632.52	Professional		$595.46	$693.59	$2,632.52
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $116.55 / $123.89 / $135.04	Professional	26	$116.55	$123.89	$135.04
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $465.95 / $569.70 / $620.97	Professional	TC	$465.95	$569.70	$620.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.02 / $642.33 / $1,631.91	Professional		$407.02	$642.33	$1,631.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.44 / $161.21 / $449.85	Professional	26	$92.44	$161.21	$449.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $288.70 / $420.44 / $1,182.05	Professional	TC	$288.70	$420.44	$1,182.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $371.65 / $831.27 / $831.27	Professional		$371.65	$831.27	$831.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $109.77 / $239.31 / $239.31	Professional	26	$109.77	$239.31	$239.31
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $261.88 / $591.96 / $591.96	Professional	TC	$261.88	$591.96	$591.96
United Facility/Professional Professional Modifier Low / Median / High Price $382.44 / $600.64 / $1,368.73	Professional		$382.44	$600.64	$1,368.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.09 / $126.50 / $368.66	Professional	26	$53.09	$126.50	$368.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $279.58 / $529.26 / $1,174.20	Professional	TC	$279.58	$529.26	$1,174.20