Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.34 / $104.70 / $132.43	Professional		$69.34	$104.70	$132.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.32 / $26.25 / $397.60	Professional	26	$22.32	$26.25	$397.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.10 / $81.15 / $100.83	Professional	TC	$43.10	$81.15	$100.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $116.61 / $116.61 / $127.10	Professional		$116.61	$116.61	$127.10
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $32.22 / $32.22 / $35.13	Professional	26	$32.22	$32.22	$35.13
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $84.38 / $84.38 / $91.97	Professional	TC	$84.38	$84.38	$91.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.74 / $66.95 / $482.74	Professional		$39.74	$66.95	$482.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.72 / $16.53 / $108.59	Professional	26	$12.72	$16.53	$108.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.86 / $50.96 / $374.15	Professional	TC	$24.86	$50.96	$374.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $143.78 / $270.41 / $270.41	Professional		$143.78	$270.41	$270.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.27 / $62.34 / $62.34	Professional	26	$34.27	$62.34	$62.34
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $109.51 / $208.07 / $208.07	Professional	TC	$109.51	$208.07	$208.07
United Facility/Professional Professional Modifier Low / Median / High Price $56.51 / $66.83 / $156.11	Professional		$56.51	$66.83	$156.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.19 / $21.69 / $65.81	Professional	26	$18.19	$21.69	$65.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.32 / $57.83 / $97.71	Professional	TC	$38.32	$57.83	$97.71