Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $376.99 / $1,125.77 / $2,988.73	Facility	26	$376.99	$1,125.77	$2,988.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,629.41 / $1,774.22 / $4,293.60	Professional		$1,629.41	$1,774.22	$4,293.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $360.93 / $376.99 / $912.31	Professional	26	$360.93	$376.99	$912.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,268.47 / $1,397.23 / $3,381.29	Professional	TC	$1,268.47	$1,397.23	$3,381.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $2,179.55 / $2,179.55 / $6,263.66	Professional		$2,179.55	$2,179.55	$6,263.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $427.87 / $427.87 / $847.70	Professional	26	$427.87	$427.87	$847.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $1,751.68 / $1,751.68 / $2,332.75	Professional	TC	$1,751.68	$1,751.68	$2,332.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,661.21 / $1,903.99 / $8,734.51	Professional		$1,661.21	$1,903.99	$8,734.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $341.00 / $425.75 / $1,833.86	Professional	26	$341.00	$425.75	$1,833.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,322.13 / $1,861.41 / $6,900.65	Professional	TC	$1,322.13	$1,861.41	$6,900.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,002.19 / $4,390.96 / $4,390.96	Professional		$2,002.19	$4,390.96	$4,390.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $432.16 / $933.84 / $933.84	Professional	26	$432.16	$933.84	$933.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $1,570.03 / $3,457.11 / $3,457.11	Professional	TC	$1,570.03	$3,457.11	$3,457.11
United Facility/Professional Professional Modifier Low / Median / High Price $1,795.55 / $4,753.30 / $6,225.30	Professional		$1,795.55	$4,753.30	$6,225.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $305.26 / $575.16 / $1,323.96	Professional	26	$305.26	$575.16	$1,323.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,490.29 / $3,817.65 / $4,901.34	Professional	TC	$1,490.29	$3,817.65	$4,901.34