Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.86 / $277.43 / $1,389.82	Facility		$22.86	$277.43	$1,389.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.27 / $54.50 / $198.52	Facility	26	$21.27	$54.50	$198.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.87 / $119.07 / $196.78	Professional		$110.87	$119.07	$196.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $21.27 / $35.07	Professional	26	$20.50	$21.27	$35.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.37 / $97.81 / $105.42	Professional	TC	$91.37	$97.81	$105.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $124.04 / $128.87 / $415.67	Professional		$124.04	$128.87	$415.67
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $22.68 / $23.37 / $25.48	Professional	26	$22.68	$23.37	$25.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $101.37 / $105.50 / $115.00	Professional	TC	$101.37	$105.50	$115.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $435.66 / $743.63 / $913.65	Facility		$435.66	$743.63	$913.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.82 / $178.23 / $403.28	Professional		$119.82	$178.23	$403.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.66 / $29.31 / $65.37	Professional	26	$21.66	$29.31	$65.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $96.61 / $148.94 / $331.25	Professional	TC	$96.61	$148.94	$331.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $121.28 / $145.56 / $280.82	Professional		$121.28	$145.56	$280.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.50 / $26.82 / $51.79	Professional	26	$23.50	$26.82	$51.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $97.78 / $118.73 / $229.02	Professional	TC	$97.78	$118.73	$229.02
United Facility/Professional Professional Modifier Low / Median / High Price $115.55 / $202.29 / $384.78	Professional		$115.55	$202.29	$384.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.05 / $27.03 / $66.03	Professional	26	$17.05	$27.03	$66.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.17 / $179.85 / $290.02	Professional	TC	$91.17	$179.85	$290.02