Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.71 / $132.62 / $227.01	Facility	26	$51.71	$132.62	$227.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $390.64 / $428.04 / $1,019.35	Professional		$390.64	$428.04	$1,019.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.71 / $56.16 / $81.06	Professional	26	$51.71	$56.16	$81.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $337.45 / $369.51 / $532.98	Professional	TC	$337.45	$369.51	$532.98
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $441.28 / $490.31 / $1,566.38	Professional		$441.28	$490.31	$1,566.38
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $56.55 / $62.84 / $83.03	Professional	26	$56.55	$62.84	$83.03
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $384.72 / $427.47 / $571.26	Professional	TC	$384.72	$427.47	$571.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $421.71 / $1,122.94 / $1,328.91	Professional		$421.71	$1,122.94	$1,328.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.84 / $135.13 / $163.13	Professional	26	$59.84	$135.13	$163.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $371.73 / $957.49 / $1,165.77	Professional	TC	$371.73	$957.49	$1,165.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $476.94 / $1,034.08 / $1,034.08	Professional		$476.94	$1,034.08	$1,034.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.53 / $124.48 / $124.48	Professional	26	$56.53	$124.48	$124.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $420.40 / $909.59 / $909.59	Professional	TC	$420.40	$909.59	$909.59
United Facility/Professional Professional Modifier Low / Median / High Price $335.00 / $1,037.31 / $1,309.50	Professional		$335.00	$1,037.31	$1,309.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.34 / $135.99 / $158.03	Professional	26	$53.34	$135.99	$158.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $286.74 / $570.36 / $1,151.85	Professional	TC	$286.74	$570.36	$1,151.85