Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $183.42 / $678.62 / $1,444.21	Facility		$183.42	$678.62	$1,444.21
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.15 / $89.60 / $318.67	Facility	26	$35.15	$89.60	$318.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.46 / $183.42 / $443.75	Professional		$174.46	$183.42	$443.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.82 / $35.15 / $57.21	Professional	26	$30.82	$35.15	$57.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $145.19 / $148.27 / $244.90	Professional	TC	$145.19	$148.27	$244.90
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $173.56 / $201.46 / $591.29	Professional		$173.56	$201.46	$591.29
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $32.97 / $34.86 / $40.77	Professional	26	$32.97	$34.86	$40.77
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $140.58 / $166.59 / $181.58	Professional	TC	$140.58	$166.59	$181.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $659.72 / $1,123.30 / $1,959.63	Facility		$659.72	$1,123.30	$1,959.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.32 / $272.08 / $600.51	Professional		$179.32	$272.08	$600.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.03 / $46.67 / $107.43	Professional	26	$34.03	$46.67	$107.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.29 / $221.18 / $502.15	Professional	TC	$146.29	$221.18	$502.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $187.22 / $224.21 / $428.82	Professional		$187.22	$224.21	$428.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.15 / $44.41 / $82.87	Professional	26	$39.15	$44.41	$82.87
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $148.07 / $179.81 / $345.97	Professional	TC	$148.07	$179.81	$345.97
United Facility/Professional Professional Modifier Low / Median / High Price $160.78 / $243.69 / $544.33	Professional		$160.78	$243.69	$544.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.34 / $47.29 / $104.95	Professional	26	$27.34	$47.29	$104.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $148.08 / $282.61 / $438.70	Professional	TC	$148.08	$282.61	$438.70