Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.52 / $159.74 / $354.78	Facility	26	$49.52	$159.74	$354.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $290.33 / $316.77 / $316.77	Professional		$290.33	$316.77	$316.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.82 / $49.52 / $117.60	Professional	26	$47.82	$49.52	$117.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $242.52 / $267.26 / $267.26	Professional	TC	$242.52	$267.26	$267.26
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $399.16 / $435.08 / $1,030.53	Professional		$399.16	$435.08	$1,030.53
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $61.47 / $61.47 / $67.00	Professional	26	$61.47	$61.47	$67.00
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $337.69 / $337.69 / $368.08	Professional	TC	$337.69	$337.69	$368.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $286.32 / $576.42 / $1,625.28	Professional		$286.32	$576.42	$1,625.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.67 / $82.94 / $246.29	Professional	26	$46.67	$82.94	$246.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.65 / $493.48 / $1,379.00	Professional	TC	$239.65	$493.48	$1,379.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $340.01 / $763.95 / $763.95	Professional		$340.01	$763.95	$763.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $55.42 / $122.02 / $122.02	Professional	26	$55.42	$122.02	$122.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $284.58 / $641.92 / $641.92	Professional	TC	$284.58	$641.92	$641.92
United Facility/Professional Professional Modifier Low / Median / High Price $321.27 / $397.69 / $1,142.79	Professional		$321.27	$397.69	$1,142.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.58 / $62.99 / $182.53	Professional	26	$45.58	$62.99	$182.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.69 / $447.48 / $960.26	Professional	TC	$275.69	$447.48	$960.26