Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $154.88 / $758.58	Facility		$125.89	$154.88	$758.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $75.86 / $190.55	Facility	26	$25.70	$75.86	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $79.43 / $363.08	Professional		$47.86	$79.43	$363.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $40.74 / $117.49	Professional	26	$25.12	$40.74	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.90 / $169.82	Professional	TC	$20.89	$30.90	$169.82
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $64.57 / $549.54	Professional		$33.88	$64.57	$549.54
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $31.62 / $85.11	Professional	26	$28.84	$31.62	$85.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $30.90 / $162.18	Professional	TC	$30.20	$30.90	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $114.82 / $234.42	Professional		$47.86	$114.82	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $37.15 / $74.13	Professional	26	$23.99	$37.15	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $50.12 / $181.97	Professional	TC	$22.91	$50.12	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $72.44 / $134.90	Professional		$67.61	$72.44	$134.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $33.88 / $66.07	Professional	26	$32.36	$33.88	$66.07
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $38.90 / $69.18	Professional	TC	$35.48	$38.90	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $81.28 / $190.55	Professional		$53.70	$81.28	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $32.36 / $85.11	Professional	26	$26.30	$32.36	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.02 / $151.36	Professional	TC	$23.99	$38.02	$151.36