Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.05 / $195.62 / $377.80	Facility	26	$42.05	$195.62	$377.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.95 / $313.58 / $758.88	Professional		$286.95	$313.58	$758.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.54 / $42.05 / $101.76	Professional	26	$40.54	$42.05	$101.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $246.40 / $271.54 / $657.12	Professional	TC	$246.40	$271.54	$657.12
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $338.98 / $369.49 / $1,003.62	Professional		$338.98	$369.49	$1,003.62
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $51.80 / $51.80 / $56.46	Professional	26	$51.80	$51.80	$56.46
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $287.18 / $287.18 / $313.02	Professional	TC	$287.18	$287.18	$313.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $283.25 / $396.50 / $1,609.60	Professional		$283.25	$396.50	$1,609.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.90 / $78.33 / $208.91	Professional	26	$39.90	$78.33	$208.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $243.34 / $318.17 / $1,400.69	Professional	TC	$243.34	$318.17	$1,400.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $336.36 / $756.73 / $756.73	Professional		$336.36	$756.73	$756.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.39 / $104.32 / $104.32	Professional	26	$47.39	$104.32	$104.32
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $288.97 / $652.40 / $652.40	Professional	TC	$288.97	$652.40	$652.40
United Facility/Professional Professional Modifier Low / Median / High Price $271.30 / $389.84 / $1,132.00	Professional		$271.30	$389.84	$1,132.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.75 / $54.35 / $156.05	Professional	26	$38.75	$54.35	$156.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $231.61 / $448.53 / $975.95	Professional	TC	$231.61	$448.53	$975.95