Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $202.21 / $576.30 / $1,683.33	Facility	26	$202.21	$576.30	$1,683.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.72 / $437.89 / $1,059.69	Professional		$407.72	$437.89	$1,059.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $193.59 / $202.21 / $944.30	Professional	26	$193.59	$202.21	$944.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $214.12 / $235.68 / $570.34	Professional	TC	$214.12	$235.68	$570.34
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $566.44 / $566.44 / $1,184.90	Professional		$566.44	$566.44	$1,184.90
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $230.12 / $230.12 / $306.06	Professional	26	$230.12	$230.12	$306.06
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $336.32 / $336.32 / $447.31	Professional	TC	$336.32	$336.32	$447.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $428.30 / $748.52 / $2,129.37	Professional		$428.30	$748.52	$2,129.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $194.97 / $334.08 / $986.98	Professional	26	$194.97	$334.08	$986.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.05 / $414.45 / $1,142.40	Professional	TC	$245.05	$414.45	$1,142.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $504.72 / $1,094.39 / $1,094.39	Professional		$504.72	$1,094.39	$1,094.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $231.52 / $501.71 / $501.71	Professional	26	$231.52	$501.71	$501.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $273.19 / $592.66 / $592.66	Professional	TC	$273.19	$592.66	$592.66
United Facility/Professional Professional Modifier Low / Median / High Price $388.29 / $697.27 / $1,551.57	Professional		$388.29	$697.27	$1,551.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $174.10 / $308.94 / $711.30	Professional	26	$174.10	$308.94	$711.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $209.92 / $621.79 / $840.27	Professional	TC	$209.92	$621.79	$840.27