Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.13 / $96.95 / $234.61	Professional		$87.13	$96.95	$234.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.81 / $71.03 / $171.89	Professional	26	$66.81	$71.03	$171.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.30 / $25.92 / $62.72	Professional	TC	$20.30	$25.92	$62.72
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $122.93 / $122.93 / $140.37	Professional		$122.93	$122.93	$140.37
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $95.88 / $95.88 / $127.52	Professional	26	$95.88	$95.88	$127.52
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.05 / $27.05 / $29.48	Professional	TC	$27.05	$27.05	$29.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.16 / $86.77 / $446.98	Professional		$53.16	$86.77	$446.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.01 / $49.85 / $327.47	Professional	26	$39.01	$49.85	$327.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.16 / $35.04 / $119.51	Professional	TC	$14.16	$35.04	$119.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $145.08 / $261.49 / $261.49	Professional		$145.08	$261.49	$261.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $105.19 / $189.73 / $189.73	Professional	26	$105.19	$189.73	$189.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $39.89 / $71.77 / $71.77	Professional	TC	$39.89	$71.77	$71.77
United Facility/Professional Professional Modifier Low / Median / High Price $79.41 / $104.11 / $276.05	Professional		$79.41	$104.11	$276.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.57 / $64.83 / $200.30	Professional	26	$54.57	$64.83	$200.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.02 / $21.36 / $132.94	Professional	TC	$16.02	$21.36	$132.94