Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $660.69 / $741.31	Facility	26	$269.15	$660.69	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,096.48 / $1,584.89	Professional		$870.96	$1,096.48	$1,584.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $371.54 / $870.96	Professional	26	$269.15	$371.54	$870.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $630.96 / $794.33 / $1,174.90	Professional	TC	$630.96	$794.33	$1,174.90
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $11,748.98 / $33,884.42	Professional		$346.74	$11,748.98	$33,884.42
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $281.84 / $281.84 / $416.87	Professional	26	$281.84	$281.84	$416.87
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $870.96 / $870.96 / $954.99	Professional	TC	$870.96	$870.96	$954.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,479.11 / $4,677.35	Professional		$1,122.02	$1,479.11	$4,677.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $309.03 / $407.38 / $1,174.90	Professional	26	$309.03	$407.38	$1,174.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $812.83 / $1,023.29 / $3,467.37	Professional	TC	$812.83	$1,023.29	$3,467.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $2,187.76 / $2,454.71	Professional		$2,187.76	$2,187.76	$2,454.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $602.56 / $602.56 / $645.65	Professional	26	$602.56	$602.56	$645.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $1,584.89 / $1,584.89 / $1,778.28	Professional	TC	$1,584.89	$1,584.89	$1,778.28
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,479.11 / $2,630.27	Professional		$1,047.13	$1,479.11	$2,630.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $275.42 / $407.38 / $741.31	Professional	26	$275.42	$407.38	$741.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $758.58 / $1,096.48 / $1,862.09	Professional	TC	$758.58	$1,096.48	$1,862.09