Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.77 / $93.77 / $93.77	Facility	26	$93.77	$93.77	$93.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.84 / $275.20 / $347.32	Professional		$238.84	$275.20	$347.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.15 / $93.77 / $100.66	Professional	26	$92.15	$93.77	$100.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $146.69 / $181.44 / $253.00	Professional	TC	$146.69	$181.44	$253.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $259.00 / $287.77 / $474.84	Professional		$259.00	$287.77	$474.84
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $94.68 / $105.20 / $121.94	Professional	26	$94.68	$105.20	$121.94
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $164.32 / $182.58 / $301.26	Professional	TC	$164.32	$182.58	$301.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.76 / $667.48 / $1,264.65	Professional		$274.76	$667.48	$1,264.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.79 / $248.46 / $424.43	Professional	26	$106.79	$248.46	$424.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.40 / $480.78 / $960.19	Professional	TC	$114.40	$480.78	$960.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $310.75 / $691.48 / $691.48	Professional		$310.75	$691.48	$691.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $100.89 / $222.95 / $222.95	Professional	26	$100.89	$222.95	$222.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $209.86 / $468.54 / $468.54	Professional	TC	$209.86	$468.54	$468.54
United Facility/Professional Professional Modifier Low / Median / High Price $203.52 / $629.87 / $875.66	Professional		$203.52	$629.87	$875.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.41 / $243.79 / $282.33	Professional	26	$84.41	$243.79	$282.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $126.80 / $449.23 / $833.69	Professional	TC	$126.80	$449.23	$833.69