Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.67 / $87.53 / $1,048.58	Facility		$65.67	$87.53	$1,048.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.26 / $41.44 / $88.06	Facility	26	$29.26	$41.44	$88.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.93 / $37.57 / $90.91	Professional		$33.93	$37.57	$90.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.14 / $13.01 / $30.80	Professional	26	$3.14	$13.01	$30.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.28 / $25.01 / $60.52	Professional	TC	$20.28	$25.01	$60.52
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $33.33 / $42.30 / $69.79	Professional		$33.33	$42.30	$69.79
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.05 / $15.94 / $17.37	Professional	26	$15.05	$15.94	$17.37
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $18.28 / $26.35 / $28.72	Professional	TC	$18.28	$26.35	$28.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.76 / $42.00 / $114.98	Professional		$30.76	$42.00	$114.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.28 / $17.82 / $42.94	Professional	26	$11.28	$17.82	$42.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.52 / $24.59 / $74.47	Professional	TC	$18.52	$24.59	$74.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.01 / $89.95 / $89.95	Professional		$43.01	$89.95	$89.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.10 / $30.29 / $30.29	Professional	26	$14.10	$30.29	$30.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.91 / $59.66 / $59.66	Professional	TC	$28.91	$59.66	$59.66
United Facility/Professional Professional Modifier Low / Median / High Price $31.59 / $48.07 / $130.33	Professional		$31.59	$48.07	$130.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.49 / $17.93 / $41.69	Professional	26	$12.49	$17.93	$41.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.73 / $27.32 / $86.44	Professional	TC	$17.73	$27.32	$86.44