Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.76 / $127.30 / $127.30	Professional		$103.76	$127.30	$127.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.69 / $33.79 / $161.49	Professional	26	$31.69	$33.79	$161.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.06 / $93.50 / $93.50	Professional	TC	$72.06	$93.50	$93.50
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $135.24 / $135.24 / $179.87	Professional		$135.24	$135.24	$179.87
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $45.38 / $45.38 / $60.36	Professional	26	$45.38	$45.38	$60.36
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $89.86 / $89.86 / $119.51	Professional	TC	$89.86	$89.86	$119.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.09 / $135.91 / $586.92	Professional		$63.09	$135.91	$586.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.59 / $43.07 / $155.86	Professional	26	$18.59	$43.07	$155.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.72 / $102.09 / $431.07	Professional	TC	$40.72	$102.09	$431.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $193.75 / $350.01 / $350.01	Professional		$193.75	$350.01	$350.01
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $50.11 / $90.35 / $90.35	Professional	26	$50.11	$90.35	$90.35
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $143.65 / $259.68 / $259.68	Professional	TC	$143.65	$259.68	$259.68
United Facility/Professional Professional Modifier Low / Median / High Price $80.33 / $123.91 / $505.62	Professional		$80.33	$123.91	$505.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.99 / $34.65 / $130.80	Professional	26	$25.99	$34.65	$130.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.34 / $72.45 / $374.82	Professional	TC	$54.34	$72.45	$374.82