Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.81 / $190.40 / $578.72	Facility	26	$66.81	$190.40	$578.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.16 / $424.59 / $1,051.40	Professional		$389.16	$424.59	$1,051.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.40 / $66.81 / $161.68	Professional	26	$64.40	$66.81	$161.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $324.75 / $357.78 / $865.82	Professional	TC	$324.75	$357.78	$865.82
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $550.74 / $732.48 / $1,936.38	Professional		$550.74	$732.48	$1,936.38
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $83.42 / $83.42 / $110.95	Professional	26	$83.42	$83.42	$110.95
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $467.32 / $467.32 / $621.54	Professional	TC	$467.32	$467.32	$621.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $384.15 / $708.80 / $1,642.28	Professional		$384.15	$708.80	$1,642.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $115.43 / $336.26	Professional	26	$63.10	$115.43	$336.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $321.06 / $593.36 / $1,864.91	Professional	TC	$321.06	$593.36	$1,864.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $456.18 / $1,032.67 / $1,032.67	Professional		$456.18	$1,032.67	$1,032.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $74.93 / $164.97 / $164.97	Professional	26	$74.93	$164.97	$164.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $381.25 / $867.72 / $867.72	Professional	TC	$381.25	$867.72	$867.72
United Facility/Professional Professional Modifier Low / Median / High Price $437.28 / $553.92 / $1,544.77	Professional		$437.28	$553.92	$1,544.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.70 / $106.53 / $246.78	Professional	26	$66.70	$106.53	$246.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $368.54 / $462.12 / $1,297.99	Professional	TC	$368.54	$462.12	$1,297.99