Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $389.05 / $1,174.90	Professional		$316.23	$389.05	$1,174.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $331.13 / $891.25	Professional	26	$93.33	$331.13	$891.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $239.88 / $676.08	Professional	TC	$208.93	$239.88	$676.08
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $323.59 / $436.52	Professional		$120.23	$323.59	$436.52
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $120.23 / $316.23	Professional	26	$120.23	$120.23	$316.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $269.15 / $398.11	Professional	TC	$72.44	$269.15	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $257.04 / $1,819.70	Professional		$151.36	$257.04	$1,819.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $83.18 / $549.54	Professional	26	$63.10	$83.18	$549.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $173.78 / $1,258.93	Professional	TC	$83.18	$173.78	$1,258.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $1,023.29 / $1,023.29	Professional		$549.54	$1,023.29	$1,023.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $309.03 / $309.03	Professional	26	$169.82	$309.03	$309.03
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $707.95 / $707.95	Professional	TC	$380.19	$707.95	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $331.13 / $954.99	Professional		$275.42	$331.13	$954.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $109.65 / $302.00	Professional	26	$97.72	$109.65	$302.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $218.78 / $660.69	Professional	TC	$177.83	$218.78	$660.69