Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.84 / $130.84 / $130.84	Facility		$130.84	$130.84	$130.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.63 / $21.63 / $21.63	Facility	26	$21.63	$21.63	$21.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.82 / $130.84 / $238.67	Professional		$113.82	$130.84	$238.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $21.63 / $30.63	Professional	26	$11.77	$21.63	$30.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.29 / $109.21 / $140.91	Professional	TC	$96.29	$109.21	$140.91
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $144.33 / $149.58 / $260.27	Professional		$144.33	$149.58	$260.27
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.77 / $21.58 / $28.70	Professional	26	$12.77	$21.58	$28.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $128.01 / $128.01 / $170.25	Professional	TC	$128.01	$128.01	$170.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $896.90 / $896.90 / $1,297.99	Facility		$896.90	$896.90	$1,297.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.51 / $235.94 / $624.21	Professional		$145.51	$235.94	$624.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.69 / $24.24 / $90.20	Professional	26	$14.69	$24.24	$90.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.55 / $220.93 / $534.01	Professional	TC	$121.55	$220.93	$534.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $140.32 / $165.08 / $350.95	Professional		$140.32	$165.08	$350.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.38 / $23.98 / $50.96	Professional	26	$20.38	$23.98	$50.96
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $119.94 / $141.10 / $299.99	Professional	TC	$119.94	$141.10	$299.99
United Facility/Professional Professional Modifier Low / Median / High Price $126.74 / $173.80 / $422.20	Professional		$126.74	$173.80	$422.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $22.00 / $61.31	Professional	26	$10.02	$22.00	$61.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $105.24 / $158.63 / $379.89	Professional	TC	$105.24	$158.63	$379.89