Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $54.95 / $104.71	Professional		$48.98	$54.95	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $54.95 / $158.49	Professional	26	$19.95	$54.95	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $33.88 / $67.61	Professional	TC	$28.84	$33.88	$67.61
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $64.57 / $79.43	Professional		$46.77	$64.57	$79.43
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $22.91 / $28.84	Professional	26	$20.89	$22.91	$28.84
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $43.65 / $43.65	Professional	TC	$20.89	$43.65	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $44.67 / $281.84	Professional		$31.62	$44.67	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $16.22 / $102.33	Professional	26	$12.30	$16.22	$102.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $27.54 / $181.97	Professional	TC	$14.79	$27.54	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $177.83 / $177.83	Professional		$112.20	$177.83	$177.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $58.88 / $58.88	Professional	26	$33.88	$58.88	$58.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $117.49 / $117.49	Professional	TC	$77.62	$117.49	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $53.70 / $165.96	Professional		$44.67	$53.70	$165.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $20.89 / $60.26	Professional	26	$19.05	$20.89	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $33.11 / $112.20	Professional	TC	$26.30	$33.11	$112.20