Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.56 / $151.50 / $193.92	Professional		$112.56	$151.50	$193.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.24 / $31.16 / $39.88	Professional	26	$29.24	$31.16	$39.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.78 / $120.34 / $154.03	Professional	TC	$75.78	$120.34	$154.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $167.35 / $167.35 / $182.41	Professional		$167.35	$167.35	$182.41
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $42.22 / $42.22 / $46.02	Professional	26	$42.22	$42.22	$46.02
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $125.13 / $125.13 / $136.38	Professional	TC	$125.13	$125.13	$136.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.67 / $105.39 / $698.48	Professional		$64.67	$105.39	$698.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.96 / $22.53 / $143.66	Professional	26	$16.96	$22.53	$143.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.80 / $82.86 / $554.80	Professional	TC	$43.80	$82.86	$554.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $225.35 / $411.54 / $411.54	Professional		$225.35	$411.54	$411.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.78 / $82.49 / $82.49	Professional	26	$45.78	$82.49	$82.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $179.57 / $329.05 / $329.05	Professional	TC	$179.57	$329.05	$329.05
United Facility/Professional Professional Modifier Low / Median / High Price $105.24 / $136.12 / $321.50	Professional		$105.24	$136.12	$321.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.04 / $27.12 / $81.90	Professional	26	$24.04	$27.12	$81.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.94 / $99.16 / $172.19	Professional	TC	$56.94	$99.16	$172.19