Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $252.86 / $613.28 / $1,307.75	Facility		$252.86	$613.28	$1,307.75
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.75 / $78.44 / $276.19	Facility	26	$30.75	$78.44	$276.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $376.06 / $563.14 / $671.26	Facility	TC	$376.06	$563.14	$671.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.35 / $194.61 / $508.65	Professional		$178.35	$194.61	$508.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.50 / $32.11 / $74.41	Professional	26	$30.50	$32.11	$74.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.19 / $161.40 / $264.01	Professional	TC	$148.19	$161.40	$264.01
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $197.11 / $197.11 / $676.78	Professional		$197.11	$197.11	$676.78
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $32.72 / $32.72 / $89.49	Professional	26	$32.72	$32.72	$89.49
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $164.39 / $164.39 / $353.36	Professional	TC	$164.39	$164.39	$353.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $711.07 / $1,214.96 / $1,959.63	Facility		$711.07	$1,214.96	$1,959.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.47 / $262.32 / $587.54	Professional		$186.47	$262.32	$587.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.36 / $43.57 / $94.05	Professional	26	$31.36	$43.57	$94.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $156.47 / $222.59 / $493.48	Professional	TC	$156.47	$222.59	$493.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $192.11 / $231.11 / $445.93	Professional		$192.11	$231.11	$445.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.54 / $37.31 / $71.73	Professional	26	$32.54	$37.31	$71.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $159.58 / $193.80 / $374.20	Professional	TC	$159.58	$193.80	$374.20
United Facility/Professional Professional Modifier Low / Median / High Price $173.29 / $319.75 / $564.71	Professional		$173.29	$319.75	$564.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.51 / $38.22 / $90.84	Professional	26	$28.51	$38.22	$90.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.13 / $215.97 / $473.19	Professional	TC	$147.13	$215.97	$473.19