Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.50 / $249.18 / $460.63	Facility	26	$51.50	$249.18	$460.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.93 / $270.61 / $789.16	Professional		$246.93	$270.61	$789.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.50 / $80.48 / $195.90	Professional	26	$51.50	$80.48	$195.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $219.11 / $357.62	Professional	TC	$162.34	$219.11	$357.62
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $258.58 / $309.33 / $1,052.82	Professional		$258.58	$309.33	$1,052.82
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $58.99 / $65.73 / $233.73	Professional	26	$58.99	$65.73	$233.73
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $183.97 / $222.81 / $415.59	Professional	TC	$183.97	$222.81	$415.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.80 / $402.20 / $916.51	Professional		$267.80	$402.20	$916.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.89 / $96.24 / $203.95	Professional	26	$53.89	$96.24	$203.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $212.79 / $320.95 / $722.95	Professional	TC	$212.79	$320.95	$722.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $271.05 / $325.57 / $628.79	Professional		$271.05	$325.57	$628.79
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $54.91 / $63.06 / $119.91	Professional	26	$54.91	$63.06	$119.91
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $216.14 / $262.50 / $508.87	Professional	TC	$216.14	$262.50	$508.87
United Facility/Professional Professional Modifier Low / Median / High Price $240.19 / $370.57 / $801.22	Professional		$240.19	$370.57	$801.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.85 / $109.60 / $153.60	Professional	26	$51.85	$109.60	$153.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $207.90 / $388.50 / $647.62	Professional	TC	$207.90	$388.50	$647.62