Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $109.65 / $213.80	Professional		$85.11	$109.65	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $75.86 / $97.72	Professional	26	$67.61	$75.86	$97.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $30.20 / $38.02	Professional	TC	$18.20	$30.20	$38.02
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $95.50 / $123.03	Professional		$29.51	$95.50	$123.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $75.86 / $75.86	Professional	26	$75.86	$75.86	$75.86
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $31.62 / $35.48	Professional	TC	$31.62	$31.62	$35.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $104.71 / $489.78	Professional		$81.28	$104.71	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $83.18 / $338.84	Professional	26	$61.66	$83.18	$338.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $27.54 / $154.88	Professional	TC	$17.38	$27.54	$154.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $208.93	Professional		$114.82	$114.82	$208.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $81.28 / $154.88	Professional	26	$81.28	$81.28	$154.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $33.88 / $53.70	Professional	TC	$33.88	$33.88	$53.70
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $87.10 / $275.42	Professional		$69.18	$87.10	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $63.10 / $190.55	Professional	26	$56.23	$63.10	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $23.99 / $81.28	Professional	TC	$13.80	$23.99	$81.28