Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $72.44 / $213.80	Professional		$67.61	$72.44	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $117.49 / $257.04	Professional	26	$46.77	$117.49	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $25.70 / $74.13	Professional	TC	$21.88	$25.70	$74.13
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $81.28 / $112.20	Professional		$29.51	$81.28	$112.20
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $57.54 / $75.86	Professional	26	$51.29	$57.54	$75.86
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $35.48 / $43.65	Professional	TC	$28.84	$35.48	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $60.26 / $371.54	Professional		$41.69	$60.26	$371.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $36.31 / $234.42	Professional	26	$26.92	$36.31	$234.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $25.70 / $138.04	Professional	TC	$13.80	$25.70	$138.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $208.93 / $208.93	Professional		$114.82	$208.93	$208.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $131.83 / $131.83	Professional	26	$72.44	$131.83	$131.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $77.62 / $77.62	Professional	TC	$41.69	$77.62	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $67.61 / $223.87	Professional		$58.88	$67.61	$223.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $46.77 / $131.83	Professional	26	$42.66	$46.77	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $21.38 / $91.20	Professional	TC	$17.38	$21.38	$91.20