Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.81 / $124.87 / $316.07	Facility	26	$43.81	$124.87	$316.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $274.93 / $300.20 / $726.50	Professional		$274.93	$300.20	$726.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.26 / $43.81 / $106.40	Professional	26	$42.26	$43.81	$106.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $232.67 / $256.39 / $620.48	Professional	TC	$232.67	$256.39	$620.48
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $352.06 / $383.75 / $1,162.66	Professional		$352.06	$383.75	$1,162.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $54.40 / $54.40 / $59.30	Professional	26	$54.40	$54.40	$59.30
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $297.66 / $297.66 / $324.45	Professional	TC	$297.66	$297.66	$324.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $270.43 / $513.19 / $1,544.95	Professional		$270.43	$513.19	$1,544.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.58 / $73.44 / $219.36	Professional	26	$41.58	$73.44	$219.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $228.85 / $439.75 / $1,325.59	Professional	TC	$228.85	$439.75	$1,325.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $321.14 / $724.03 / $724.03	Professional		$321.14	$724.03	$724.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $49.38 / $108.71 / $108.71	Professional	26	$49.38	$108.71	$108.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $271.76 / $615.32 / $615.32	Professional	TC	$271.76	$615.32	$615.32
United Facility/Professional Professional Modifier Low / Median / High Price $285.89 / $375.09 / $1,083.07	Professional		$285.89	$375.09	$1,083.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.35 / $70.95 / $162.62	Professional	26	$40.35	$70.95	$162.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.55 / $325.04 / $920.45	Professional	TC	$245.55	$325.04	$920.45