Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.15 / $101.20 / $450.18	Facility		$23.15	$101.20	$450.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.34 / $27.33 / $69.15	Facility	26	$22.34	$27.33	$69.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $69.30 / $201.71 / $248.54	Facility	TC	$69.30	$201.71	$248.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.25 / $38.22 / $92.51	Professional		$35.25	$38.22	$92.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.23 / $10.17 / $23.20	Professional	26	$9.23	$10.17	$23.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.02 / $28.64 / $69.30	Professional	TC	$26.02	$28.64	$69.30
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $39.38 / $44.20 / $100.04	Professional		$39.38	$44.20	$100.04
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.30 / $12.68 / $13.82	Professional	26	$11.30	$12.68	$13.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.09 / $31.52 / $34.36	Professional	TC	$28.09	$31.52	$34.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.35 / $207.94 / $729.07	Facility		$135.35	$207.94	$729.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.77 / $48.37 / $162.94	Professional		$34.77	$48.37	$162.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.15 / $15.53 / $40.86	Professional	26	$9.15	$15.53	$40.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.54 / $31.84 / $122.08	Professional	TC	$24.54	$31.84	$122.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $93.93 / $93.93	Professional		$42.66	$93.93	$93.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $23.78 / $23.78	Professional	26	$10.80	$23.78	$23.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.86 / $70.15 / $70.15	Professional	TC	$31.86	$70.15	$70.15
United Facility/Professional Professional Modifier Low / Median / High Price $30.18 / $41.89 / $119.02	Professional		$30.18	$41.89	$119.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.23 / $12.17 / $30.14	Professional	26	$9.23	$12.17	$30.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.34 / $39.67 / $88.88	Professional	TC	$21.34	$39.67	$88.88