Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.13 / $129.68 / $149.01	Professional		$110.13	$129.68	$149.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.47 / $13.91 / $16.17	Professional	26	$13.47	$13.91	$16.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.97 / $115.77 / $132.91	Professional	TC	$93.97	$115.77	$132.91
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $90.81 / $137.47 / $157.41	Professional		$90.81	$137.47	$157.41
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.32 / $16.96 / $18.37	Professional	26	$15.32	$16.96	$18.37
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $75.48 / $119.10 / $140.44	Professional	TC	$75.48	$119.10	$140.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.49 / $134.74 / $386.54	Professional		$97.49	$134.74	$386.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.87 / $16.03 / $42.02	Professional	26	$11.87	$16.03	$42.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.43 / $120.78 / $344.52	Professional	TC	$84.43	$120.78	$344.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.40 / $151.40 / $151.40	Professional		$151.40	$151.40	$151.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.69 / $15.69 / $15.69	Professional	26	$15.69	$15.69	$15.69
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $135.71 / $135.71 / $135.71	Professional	TC	$135.71	$135.71	$135.71
United Facility/Professional Professional Modifier Low / Median / High Price $66.87 / $105.98 / $382.93	Professional		$66.87	$105.98	$382.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.98 / $14.23 / $40.69	Professional	26	$10.98	$14.23	$40.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.86 / $95.00 / $343.43	Professional	TC	$59.86	$95.00	$343.43