Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $47.86 / $204.17	Professional		$40.74	$47.86	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $87.10 / $218.78	Professional	26	$26.92	$87.10	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $16.98 / $51.29	Professional	TC	$14.13	$16.98	$51.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $44.67 / $89.13	Professional		$26.30	$44.67	$89.13
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $29.51 / $85.11	Professional	26	$26.30	$29.51	$85.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $19.05 / $22.39	Professional	TC	$18.20	$19.05	$22.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $32.36 / $223.87	Professional		$25.70	$32.36	$223.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $20.42 / $134.90	Professional	26	$15.49	$20.42	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.47 / $12.59 / $89.13	Professional	TC	$10.47	$12.59	$89.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $128.82 / $128.82	Professional		$70.79	$128.82	$128.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $75.86 / $75.86	Professional	26	$41.69	$75.86	$75.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $52.48 / $52.48	Professional	TC	$28.84	$52.48	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $42.66 / $120.23	Professional		$37.15	$42.66	$120.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $26.92 / $74.13	Professional	26	$24.55	$26.92	$74.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $15.49 / $48.98	Professional	TC	$12.59	$15.49	$48.98