Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.73 / $91.73 / $663.04	Facility	26	$91.73	$91.73	$663.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $305.88 / $332.01 / $803.46	Professional		$305.88	$332.01	$803.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.82 / $91.73 / $177.80	Professional	26	$87.82	$91.73	$177.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.05 / $240.27 / $581.45	Professional	TC	$218.05	$240.27	$581.45
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $380.28 / $380.28 / $3,741.34	Professional		$380.28	$380.28	$3,741.34
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $112.07 / $112.07 / $149.05	Professional	26	$112.07	$112.07	$149.05
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $268.20 / $268.20 / $356.72	Professional	TC	$268.20	$268.20	$356.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.68 / $513.62 / $1,638.64	Professional		$316.68	$513.62	$1,638.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.77 / $151.77 / $450.15	Professional	26	$88.77	$151.77	$450.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.54 / $361.84 / $1,188.48	Professional	TC	$220.54	$361.84	$1,188.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $376.06 / $824.81 / $824.81	Professional		$376.06	$824.81	$824.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $105.41 / $228.05 / $228.05	Professional	26	$105.41	$228.05	$228.05
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $270.66 / $596.74 / $596.74	Professional	TC	$270.66	$596.74	$596.74
United Facility/Professional Professional Modifier Low / Median / High Price $269.62 / $488.66 / $1,169.38	Professional		$269.62	$488.66	$1,169.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.84 / $141.13 / $323.32	Professional	26	$78.84	$141.13	$323.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.78 / $347.53 / $846.06	Professional	TC	$190.78	$347.53	$846.06