Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.92 / $136.81 / $173.30	Professional		$100.92	$136.81	$173.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.65 / $29.12 / $70.47	Professional	26	$27.65	$29.12	$70.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.92 / $107.69 / $134.16	Professional	TC	$62.92	$107.69	$134.16
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $97.60 / $150.86 / $164.44	Professional		$97.60	$150.86	$164.44
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $39.84 / $39.84 / $52.99	Professional	26	$39.84	$39.84	$52.99
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $111.02 / $121.01	Professional	TC	$19.54	$111.02	$121.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.14 / $88.15 / $630.75	Professional		$55.14	$88.15	$630.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.73 / $26.13 / $134.26	Professional	26	$15.73	$26.13	$134.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.01 / $51.69 / $496.49	Professional	TC	$29.01	$51.69	$496.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $188.26 / $356.13 / $356.13	Professional		$188.26	$356.13	$356.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $42.39 / $77.09 / $77.09	Professional	26	$42.39	$77.09	$77.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $145.87 / $279.02 / $279.02	Professional	TC	$145.87	$279.02	$279.02
United Facility/Professional Professional Modifier Low / Median / High Price $77.09 / $99.01 / $229.15	Professional		$77.09	$99.01	$229.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.52 / $29.74 / $87.40	Professional	26	$22.52	$29.74	$87.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.44 / $72.76 / $262.17	Professional	TC	$52.44	$72.76	$262.17