Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.42 / $284.73 / $491.38	Facility	26	$111.42	$284.73	$491.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $593.96 / $702.22 / $1,541.53	Professional		$593.96	$702.22	$1,541.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.42 / $119.81 / $173.68	Professional	26	$111.42	$119.81	$173.68
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $296.98 / $318.50 / $336.16	Professional	52	$296.98	$318.50	$336.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $486.97 / $552.50 / $810.53	Professional	TC	$486.97	$552.50	$810.53
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $689.82 / $766.47 / $1,870.07	Professional		$689.82	$766.47	$1,870.07
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $121.75 / $135.27 / $223.20	Professional	26	$121.75	$135.27	$223.20
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $568.08 / $631.20 / $1,041.48	Professional	TC	$568.08	$631.20	$1,041.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $752.21 / $1,462.55 / $2,009.69	Professional		$752.21	$1,462.55	$2,009.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.86 / $290.12 / $351.51	Professional	26	$128.86	$290.12	$351.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $623.34 / $1,193.48 / $1,658.17	Professional	TC	$623.34	$1,193.48	$1,658.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $710.62 / $1,554.24 / $1,554.24	Professional		$710.62	$1,554.24	$1,554.24
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $121.74 / $267.26 / $267.26	Professional	26	$121.74	$267.26	$267.26
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $588.88 / $1,286.98 / $1,286.98	Professional	TC	$588.88	$1,286.98	$1,286.98
United Facility/Professional Professional Modifier Low / Median / High Price $607.33 / $917.48 / $1,968.22	Professional		$607.33	$917.48	$1,968.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $113.44 / $291.08 / $338.45	Professional	26	$113.44	$291.08	$338.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $495.95 / $818.81 / $1,629.77	Professional	TC	$495.95	$818.81	$1,629.77