Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.18 / $126.27 / $141.63	Facility	26	$52.18	$126.27	$141.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.81 / $372.06 / $518.22	Professional		$302.81	$372.06	$518.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.32 / $52.18 / $98.09	Professional	26	$51.32	$52.18	$98.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.27 / $317.01 / $636.05	Professional	TC	$251.27	$317.01	$636.05
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $352.79 / $391.99 / $587.47	Professional		$352.79	$391.99	$587.47
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $48.65 / $54.05 / $89.18	Professional	26	$48.65	$54.05	$89.18
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $304.14 / $337.94 / $368.35	Professional	TC	$304.14	$337.94	$368.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $303.39 / $1,004.22 / $1,700.59	Professional		$303.39	$1,004.22	$1,700.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.44 / $137.18 / $235.95	Professional	26	$59.44	$137.18	$235.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.22 / $896.50 / $1,464.64	Professional	TC	$213.22	$896.50	$1,464.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $421.09 / $945.73 / $945.73	Professional		$421.09	$945.73	$945.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.30 / $124.75 / $124.75	Professional	26	$56.30	$124.75	$124.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $364.80 / $820.99 / $820.99	Professional	TC	$364.80	$820.99	$820.99
United Facility/Professional Professional Modifier Low / Median / High Price $165.72 / $488.12 / $1,197.63	Professional		$165.72	$488.12	$1,197.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.49 / $75.34 / $157.97	Professional	26	$43.49	$75.34	$157.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.29 / $494.90 / $1,039.66	Professional	TC	$152.29	$494.90	$1,039.66