Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $194.98 / $204.17	Professional		$169.82	$194.98	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $100.00 / $102.33	Professional	26	$91.20	$100.00	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $91.20 / $102.33	Professional	TC	$79.43	$91.20	$102.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $186.21 / $257.04	Professional		$38.02	$186.21	$257.04
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $112.20 / $147.91	Professional	26	$100.00	$112.20	$147.91
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $109.65 / $134.90	Professional	TC	$81.28	$109.65	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $158.49 / $933.25	Professional		$109.65	$158.49	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $457.09	Professional	26	$52.48	$72.44	$457.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $89.13 / $478.63	Professional	TC	$50.12	$89.13	$478.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $549.54 / $549.54	Professional		$288.40	$549.54	$549.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $263.03 / $263.03	Professional	26	$138.04	$263.03	$263.03
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $281.84 / $281.84	Professional	TC	$151.36	$281.84	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $177.83 / $588.84	Professional		$154.88	$177.83	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $95.50 / $269.15	Professional	26	$87.10	$95.50	$269.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $85.11 / $323.59	Professional	TC	$69.18	$85.11	$323.59