Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.98 / $645.61 / $2,770.56	Facility		$195.98	$645.61	$2,770.56
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.94 / $205.39 / $424.24	Facility	26	$33.94	$205.39	$424.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.98 / $217.58 / $785.44	Professional		$195.98	$217.58	$785.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.91 / $64.20 / $235.24	Professional	26	$62.91	$64.20	$235.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $133.06 / $156.49 / $580.04	Professional	TC	$133.06	$156.49	$580.04
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $220.01 / $220.01 / $753.93	Professional		$220.01	$220.01	$753.93
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $67.53 / $67.53 / $169.83	Professional	26	$67.53	$67.53	$169.83
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $152.47 / $152.47 / $396.25	Professional	TC	$152.47	$152.47	$396.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.29 / $317.29 / $747.32	Professional		$198.29	$317.29	$747.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.20 / $94.28 / $239.91	Professional	26	$66.20	$94.28	$239.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $137.10 / $229.39 / $507.41	Professional	TC	$137.10	$229.39	$507.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $200.38 / $239.35 / $461.59	Professional		$200.38	$239.35	$461.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $68.00 / $78.63 / $149.51	Professional	26	$68.00	$78.63	$149.51
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $132.38 / $160.72 / $312.08	Professional	TC	$132.38	$160.72	$312.08
United Facility/Professional Professional Modifier Low / Median / High Price $182.70 / $274.77 / $730.83	Professional		$182.70	$274.77	$730.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.35 / $94.04 / $219.25	Professional	26	$59.35	$94.04	$219.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $126.74 / $183.81 / $538.51	Professional	TC	$126.74	$183.81	$538.51