Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $145.18 / $351.33 / $394.05	Facility	26	$145.18	$351.33	$394.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.57 / $248.78 / $583.84	Professional		$230.57	$248.78	$583.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $142.35 / $145.18 / $219.71	Professional	26	$142.35	$145.18	$219.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.22 / $104.53 / $144.33	Professional	TC	$88.22	$104.53	$144.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $219.08 / $243.42 / $401.64	Professional		$219.08	$243.42	$401.64
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $128.22 / $142.46 / $235.06	Professional	26	$128.22	$142.46	$235.06
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $90.86 / $100.96 / $166.58	Professional	TC	$90.86	$100.96	$166.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $268.20 / $629.76 / $1,044.52	Professional		$268.20	$629.76	$1,044.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $165.86 / $373.80 / $657.50	Professional	26	$165.86	$373.80	$657.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.34 / $254.58 / $387.02	Professional	TC	$102.34	$254.58	$387.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $253.37 / $569.22 / $569.22	Professional		$253.37	$569.22	$569.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $156.68 / $344.22 / $344.22	Professional	26	$156.68	$344.22	$344.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $96.69 / $225.00 / $225.00	Professional	TC	$96.69	$225.00	$225.00
United Facility/Professional Professional Modifier Low / Median / High Price $204.43 / $341.55 / $732.44	Professional		$204.43	$341.55	$732.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $130.40 / $317.36 / $435.90	Professional	26	$130.40	$317.36	$435.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.13 / $145.07 / $301.91	Professional	TC	$88.13	$145.07	$301.91