Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.19 / $353.20 / $637.27	Facility		$148.19	$353.20	$637.27
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.86 / $148.29 / $201.71	Facility	26	$36.86	$148.29	$201.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.19 / $183.93 / $358.64	Professional		$148.19	$183.93	$358.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.86 / $49.38 / $71.48	Professional	26	$36.86	$49.38	$71.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.32 / $134.55 / $182.19	Professional	TC	$111.32	$134.55	$182.19
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $156.44 / $185.48 / $202.17	Professional		$156.44	$185.48	$202.17
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $41.76 / $48.35 / $52.70	Professional	26	$41.76	$48.35	$52.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $114.70 / $137.13 / $149.47	Professional	TC	$114.70	$137.13	$149.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $335.81 / $335.81 / $348.80	Facility		$335.81	$335.81	$348.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.50 / $329.50 / $470.80	Professional		$145.50	$329.50	$470.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.83 / $87.09 / $116.34	Professional	26	$40.83	$87.09	$116.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.67 / $240.21 / $351.22	Professional	TC	$104.67	$240.21	$351.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $137.46 / $321.23 / $321.23	Professional		$137.46	$321.23	$321.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.58 / $85.74 / $85.74	Professional	26	$38.58	$85.74	$85.74
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $98.89 / $235.49 / $235.49	Professional	TC	$98.89	$235.49	$235.49
United Facility/Professional Professional Modifier Low / Median / High Price $160.82 / $362.04 / $476.44	Professional		$160.82	$362.04	$476.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.42 / $64.08 / $118.98	Professional	26	$37.42	$64.08	$118.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $118.29 / $193.80 / $365.57	Professional	TC	$118.29	$193.80	$365.57