Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $202.21 / $858.50 / $1,707.23	Facility	26	$202.21	$858.50	$1,707.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $420.48 / $452.04 / $578.61	Professional		$420.48	$452.04	$578.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $193.59 / $202.21 / $484.39	Professional	26	$193.59	$202.21	$484.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $226.89 / $249.83 / $347.18	Professional	TC	$226.89	$249.83	$347.18
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $496.13 / $496.13 / $4,634.39	Professional		$496.13	$496.13	$4,634.39
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $244.63 / $244.63 / $577.94	Professional	26	$244.63	$244.63	$577.94
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $251.50 / $251.50 / $2,332.75	Professional	TC	$251.50	$251.50	$2,332.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $434.90 / $1,045.05 / $2,210.17	Professional		$434.90	$1,045.05	$2,210.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $194.97 / $348.76 / $986.98	Professional	26	$194.97	$348.76	$986.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.94 / $655.79 / $1,861.41	Professional	TC	$239.94	$655.79	$1,861.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $516.45 / $1,123.45 / $1,123.45	Professional		$516.45	$1,123.45	$1,123.45
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $231.52 / $500.92 / $500.92	Professional	26	$231.52	$500.92	$500.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $284.92 / $622.53 / $622.53	Professional	TC	$284.92	$622.53	$622.53
United Facility/Professional Professional Modifier Low / Median / High Price $407.82 / $763.36 / $4,012.17	Professional		$407.82	$763.36	$4,012.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $174.20 / $211.05 / $1,283.92	Professional	26	$174.20	$211.05	$1,283.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $209.92 / $596.45 / $2,728.25	Professional	TC	$209.92	$596.45	$2,728.25