Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $102.33 / $457.09	Facility		$89.13	$102.33	$457.09
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $27.54 / $69.18	Facility	26	$8.91	$27.54	$69.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.18 / $81.28 / $204.17	Facility	TC	$28.18	$81.28	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $51.29 / $117.49	Professional		$30.90	$51.29	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.45 / $33.88	Professional	26	$8.91	$14.45	$33.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.20 / $79.43	Professional	TC	$21.88	$30.20	$79.43
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $40.74 / $134.90	Professional		$11.22	$40.74	$134.90
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.47 / $12.59	Professional	26	$10.23	$10.47	$12.59
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.20 / $36.31	Professional	TC	$23.99	$30.20	$36.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $208.93 / $239.88	Facility		$134.90	$208.93	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $42.66 / $114.82	Professional		$32.36	$42.66	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.88 / $28.84	Professional	26	$9.12	$12.88	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $28.84 / $72.44	Professional	TC	$23.44	$28.84	$72.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $50.12 / $93.33	Professional		$42.66	$50.12	$93.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $12.30 / $23.99	Professional	26	$10.72	$12.30	$23.99
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $38.02 / $70.79	Professional	TC	$31.62	$38.02	$70.79
United Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $416.87 / $489.78	Facility		$363.08	$416.87	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $45.71 / $120.23	Professional		$30.20	$45.71	$120.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $13.49 / $30.20	Professional	26	$8.51	$13.49	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.11 / $89.13	Professional	TC	$21.88	$33.11	$89.13