Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $64.57 / $141.25	Professional		$47.86	$64.57	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $37.15 / $120.23	Professional	26	$28.18	$37.15	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $23.99 / $38.02	Professional	TC	$19.05	$23.99	$38.02
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $37.15 / $44.67	Professional		$12.30	$37.15	$44.67
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $25.12 / $27.54	Professional	26	$25.12	$25.12	$27.54
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $13.49 / $19.05	Professional	TC	$13.49	$13.49	$19.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $57.54 / $199.53	Professional		$44.67	$57.54	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $35.48 / $112.20	Professional	26	$27.54	$35.48	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $25.70 / $89.13	Professional	TC	$19.95	$25.70	$89.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $131.83	Professional		$72.44	$72.44	$131.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $39.81 / $74.13	Professional	26	$39.81	$39.81	$74.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $33.11 / $56.23	Professional	TC	$33.11	$33.11	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $52.48 / $158.49	Professional		$40.74	$52.48	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $30.20 / $91.20	Professional	26	$25.12	$30.20	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $22.39 / $70.79	Professional	TC	$14.79	$22.39	$70.79