Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $270.77 / $655.26 / $734.95	Facility	26	$270.77	$655.26	$734.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,051.78 / $1,051.78 / $2,854.81	Professional		$1,051.78	$1,051.78	$2,854.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $270.77 / $270.77 / $734.95	Professional	26	$270.77	$270.77	$734.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $781.00 / $781.00 / $2,119.87	Professional	TC	$781.00	$781.00	$2,119.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $1,194.46 / $1,242.08 / $18,213.61	Professional		$1,194.46	$1,242.08	$18,213.61
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $314.82 / $327.29 / $356.75	Professional	26	$314.82	$327.29	$356.75
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $879.64 / $914.78 / $997.11	Professional	TC	$879.64	$914.78	$997.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,038.08 / $1,464.99 / $4,667.51	Professional		$1,038.08	$1,464.99	$4,667.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $297.13 / $404.53 / $1,168.16	Professional	26	$297.13	$404.53	$1,168.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $740.96 / $1,018.05 / $3,499.35	Professional	TC	$740.96	$1,018.05	$3,499.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,427.98 / $2,427.98 / $2,427.98	Professional		$2,427.98	$2,427.98	$2,427.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $639.92 / $639.92 / $639.92	Professional	26	$639.92	$639.92	$639.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $1,788.04 / $1,788.04 / $1,788.04	Professional	TC	$1,788.04	$1,788.04	$1,788.04
United Facility/Professional Professional Modifier Low / Median / High Price $1,045.96 / $1,813.79 / $2,625.96	Professional		$1,045.96	$1,813.79	$2,625.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $275.62 / $482.03 / $743.23	Professional	26	$275.62	$482.03	$743.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $589.58 / $1,096.26 / $1,882.73	Professional	TC	$589.58	$1,096.26	$1,882.73