Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.26 / $722.97 / $1,228.95	Facility		$245.26	$722.97	$1,228.95
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.44 / $153.02 / $312.02	Facility	26	$34.44	$153.02	$312.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $210.82 / $606.46 / $1,304.49	Facility	TC	$210.82	$606.46	$1,304.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.31 / $245.26 / $624.40	Professional		$189.31	$245.26	$624.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $34.44 / $63.58	Professional	26	$26.96	$34.44	$63.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $210.82 / $345.46	Professional	TC	$162.34	$210.82	$345.46
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $197.30 / $221.18 / $829.64	Professional		$197.30	$221.18	$829.64
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $29.09 / $32.26 / $35.15	Professional	26	$29.09	$32.26	$35.15
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $166.90 / $192.09 / $201.42	Professional	TC	$166.90	$192.09	$201.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $930.46 / $1,597.25 / $2,117.03	Facility		$930.46	$1,597.25	$2,117.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.95 / $339.89 / $758.29	Professional		$235.95	$339.89	$758.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.31 / $46.76 / $106.23	Professional	26	$31.31	$46.76	$106.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $201.58 / $292.54 / $652.05	Professional	TC	$201.58	$292.54	$652.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $246.12 / $296.35 / $574.03	Professional		$246.12	$296.35	$574.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.29 / $42.76 / $82.10	Professional	26	$37.29	$42.76	$82.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $208.82 / $253.59 / $491.93	Professional	TC	$208.82	$253.59	$491.93
United Facility/Professional Professional Modifier Low / Median / High Price $232.88 / $348.99 / $726.93	Professional		$232.88	$348.99	$726.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.14 / $46.76 / $103.97	Professional	26	$24.14	$46.76	$103.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.67 / $460.99 / $622.96	Professional	TC	$213.67	$460.99	$622.96