Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $281.84 / $446.68	Facility	26	$112.20	$281.84	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $741.31 / $1,412.54	Professional		$588.84	$741.31	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $165.96 / $467.74	Professional	26	$114.82	$165.96	$467.74
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $295.12 / $371.54 / $1,258.93	Professional	52	$295.12	$371.54	$1,258.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $562.34 / $977.24	Professional	TC	$478.63	$562.34	$977.24
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $794.33 / $3,467.37	Professional		$120.23	$794.33	$3,467.37
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $134.90 / $489.78	Professional	26	$131.83	$134.90	$489.78
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $645.65 / $776.25	Professional	TC	$588.84	$645.65	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,288.25 / $1,995.26	Professional		$812.83	$1,288.25	$1,995.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $234.42 / $338.84	Professional	26	$147.91	$234.42	$338.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $1,047.13 / $1,584.89	Professional	TC	$660.69	$1,047.13	$1,584.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $912.01 / $1,548.82	Professional		$776.25	$912.01	$1,548.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $147.91 / $269.15	Professional	26	$128.82	$147.91	$269.15
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $758.58 / $1,288.25	Professional	TC	$660.69	$758.58	$1,288.25
United Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $1,258.93 / $1,949.84	Professional		$616.60	$1,258.93	$1,949.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $229.09 / $338.84	Professional	26	$112.20	$229.09	$338.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $1,047.13 / $1,621.81	Professional	TC	$512.86	$1,047.13	$1,621.81