Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $794.33 / $2,754.23	Facility		$457.09	$794.33	$2,754.23
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $158.49 / $251.19	Facility	26	$61.66	$158.49	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $316.23 / $831.76	Professional		$181.97	$316.23	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $75.86 / $213.80	Professional	26	$60.26	$75.86	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $173.78 / $575.44	Professional	TC	$117.49	$173.78	$575.44
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $239.88 / $1,096.48	Professional		$158.49	$239.88	$1,096.48
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $70.79 / $177.83	Professional	26	$64.57	$70.79	$177.83
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $144.54 / $407.38	Professional	TC	$131.83	$144.54	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $295.12 / $537.03	Professional		$190.55	$295.12	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $87.10 / $162.18	Professional	26	$66.07	$87.10	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $204.17 / $371.54	Professional	TC	$138.04	$204.17	$371.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $223.87 / $457.09	Professional		$208.93	$223.87	$457.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $74.13 / $147.91	Professional	26	$69.18	$74.13	$147.91
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $151.36 / $309.03	Professional	TC	$138.04	$151.36	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,630.27 / $3,090.30	Facility		$2,238.72	$2,630.27	$3,090.30
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $251.19 / $691.83	Professional		$190.55	$251.19	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $81.28 / $204.17	Professional	26	$60.26	$81.28	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $181.97 / $478.63	Professional	TC	$125.89	$181.97	$478.63