Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $276.62 / $400.49 / $1,143.08	Facility		$276.62	$400.49	$1,143.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.77 / $49.83 / $178.70	Facility	26	$19.77	$49.83	$178.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $237.54 / $283.70 / $413.04	Facility	TC	$237.54	$283.70	$413.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.19 / $121.72 / $294.56	Professional		$24.19	$121.72	$294.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.77 / $21.03 / $47.84	Professional	26	$19.77	$21.03	$47.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.58 / $101.95 / $168.67	Professional	TC	$93.58	$101.95	$168.67
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $125.56 / $125.56 / $460.72	Professional		$125.56	$125.56	$460.72
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $21.35 / $21.35 / $58.24	Professional	26	$21.35	$21.35	$58.24
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $104.21 / $104.21 / $251.21	Professional	TC	$104.21	$104.21	$251.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $454.34 / $772.44 / $944.32	Facility		$454.34	$772.44	$944.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.65 / $172.02 / $372.58	Professional		$118.65	$172.02	$372.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.27 / $28.06 / $59.76	Professional	26	$20.27	$28.06	$59.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.08 / $139.49 / $312.82	Professional	TC	$99.08	$139.49	$312.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.97 / $147.94 / $283.74	Professional		$122.97	$147.94	$283.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.00 / $24.11 / $45.84	Professional	26	$21.00	$24.11	$45.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $101.97 / $123.83 / $237.91	Professional	TC	$101.97	$123.83	$237.91
United Facility/Professional Professional Modifier Low / Median / High Price $116.34 / $158.49 / $352.82	Professional		$116.34	$158.49	$352.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.86 / $34.27 / $59.32	Professional	26	$18.86	$34.27	$59.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.90 / $135.26 / $293.50	Professional	TC	$88.90	$135.26	$293.50