Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.19 / $81.51 / $197.25	Professional		$75.19	$81.51	$197.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.71 / $40.43	Professional	26	$16.22	$16.71	$40.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.98 / $64.80 / $156.81	Professional	TC	$58.98	$64.80	$156.81
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $70.09 / $96.76 / $105.47	Professional		$70.09	$96.76	$105.47
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $23.28 / $23.28 / $26.68	Professional	26	$23.28	$23.28	$26.68
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $50.00 / $73.48 / $80.09	Professional	TC	$50.00	$73.48	$80.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.04 / $58.67 / $375.80	Professional		$40.04	$58.67	$375.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.75 / $13.79 / $77.04	Professional	26	$8.75	$13.79	$77.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.15 / $38.18 / $298.75	Professional	TC	$31.15	$38.18	$298.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.67 / $210.38 / $210.38	Professional		$111.67	$210.38	$210.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.45 / $43.46 / $43.46	Professional	26	$23.45	$43.46	$43.46
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $88.22 / $166.93 / $166.93	Professional	TC	$88.22	$166.93	$166.93
United Facility/Professional Professional Modifier Low / Median / High Price $59.11 / $76.41 / $170.04	Professional		$59.11	$76.41	$170.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.86 / $16.53 / $46.70	Professional	26	$13.86	$16.53	$46.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.55 / $60.34 / $176.22	Professional	TC	$45.55	$60.34	$176.22