Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.77 / $41.77 / $41.77	Facility	26	$41.77	$41.77	$41.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.89 / $372.15 / $372.15	Professional		$292.89	$372.15	$372.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $166.87 / $186.08 / $186.08	Professional	52	$166.87	$186.08	$186.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $252.77 / $323.49 / $330.38	Professional	TC	$252.77	$323.49	$330.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $328.20 / $364.67 / $397.49	Professional		$328.20	$364.67	$397.49
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $291.08 / $323.43 / $352.54	Professional	TC	$291.08	$323.43	$352.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $358.57 / $873.68 / $1,635.85	Professional		$358.57	$873.68	$1,635.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $318.67 / $764.61 / $1,447.37	Professional	TC	$318.67	$764.61	$1,447.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $405.52 / $899.37 / $899.37	Professional		$405.52	$899.37	$899.37
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.12 / $99.36 / $99.36	Professional	26	$45.12	$99.36	$99.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $360.40 / $800.01 / $800.01	Professional	TC	$360.40	$800.01	$800.01
United Facility/Professional Professional Modifier Low / Median / High Price $282.66 / $454.63 / $1,138.91	Professional		$282.66	$454.63	$1,138.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.79 / $397.88 / $1,013.09	Professional	TC	$244.79	$397.88	$1,013.09