Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $380.19 / $1,148.15 / $2,691.53	Facility	26	$380.19	$1,148.15	$2,691.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,041.74 / $6,025.60	Professional		$1,479.11	$2,041.74	$6,025.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $309.03 / $562.34 / $1,995.26	Professional	26	$309.03	$562.34	$1,995.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,122.02 / $1,584.89 / $6,309.57	Professional	TC	$1,122.02	$1,584.89	$6,309.57
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $5,128.61 / $8,511.38	Professional		$1,949.84	$5,128.61	$8,511.38
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $416.87 / $501.19 / $870.96	Professional	26	$416.87	$501.19	$870.96
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $1,513.56 / $1,621.81 / $2,398.83	Professional	TC	$1,513.56	$1,621.81	$2,398.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,905.46 / $7,413.10	Professional		$1,659.59	$1,905.46	$7,413.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $338.84 / $380.19 / $1,548.82	Professional	26	$338.84	$380.19	$1,548.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,318.26 / $1,513.56 / $6,918.31	Professional	TC	$1,318.26	$1,513.56	$6,918.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $2,511.89 / $4,365.16	Professional		$2,187.76	$2,511.89	$4,365.16
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $436.52 / $512.86 / $933.25	Professional	26	$436.52	$512.86	$933.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $1,737.80 / $1,995.26 / $3,467.37	Professional	TC	$1,737.80	$1,995.26	$3,467.37
United Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,344.23 / $6,165.95	Professional		$1,698.24	$2,344.23	$6,165.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $302.00 / $501.19 / $1,318.26	Professional	26	$302.00	$501.19	$1,318.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,412.54 / $1,862.09 / $4,897.79	Professional	TC	$1,412.54	$1,862.09	$4,897.79