Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.87 / $109.51 / $109.51	Professional		$87.87	$109.51	$109.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.77 / $26.81 / $92.40	Professional	26	$24.77	$26.81	$92.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $82.69 / $82.69	Professional	TC	$63.10	$82.69	$82.69
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $114.00 / $114.00 / $124.26	Professional		$114.00	$114.00	$124.26
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $35.39 / $35.39 / $38.58	Professional	26	$35.39	$35.39	$38.58
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $78.61 / $78.61 / $85.68	Professional	TC	$78.61	$78.61	$85.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.61 / $75.33 / $504.89	Professional		$40.61	$75.33	$504.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.91 / $18.44 / $123.62	Professional	26	$12.91	$18.44	$123.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.70 / $56.88 / $381.26	Professional	TC	$27.70	$56.88	$381.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.28 / $304.08 / $304.08	Professional		$170.28	$304.08	$304.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.38 / $71.81 / $71.81	Professional	26	$40.38	$71.81	$71.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $129.90 / $232.28 / $232.28	Professional	TC	$129.90	$232.28	$232.28
United Facility/Professional Professional Modifier Low / Median / High Price $69.94 / $82.82 / $159.63	Professional		$69.94	$82.82	$159.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.78 / $24.12 / $50.71	Professional	26	$16.78	$24.12	$50.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.02 / $65.59 / $245.21	Professional	TC	$36.02	$65.59	$245.21