Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.04 / $93.05 / $364.14	Facility		$25.04	$93.05	$364.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.23 / $24.78 / $62.65	Facility	26	$20.23	$24.78	$62.65
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $55.75 / $171.99 / $326.19	Facility	TC	$55.75	$171.99	$326.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.32 / $31.73 / $77.59	Professional		$29.32	$31.73	$77.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $9.64 / $21.02	Professional	26	$8.36	$9.64	$21.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.95 / $23.04 / $25.57	Professional	TC	$20.95	$23.04	$25.57
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $36.44 / $36.69 / $105.61	Professional		$36.44	$36.69	$105.61
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $11.91 / $12.98	Professional	26	$10.72	$11.91	$12.98
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.30 / $24.78 / $28.31	Professional	TC	$22.30	$24.78	$28.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.90 / $183.26 / $896.90	Facility		$108.90	$183.26	$896.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.83 / $48.50 / $135.00	Professional		$29.83	$48.50	$135.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.28 / $14.94 / $37.03	Professional	26	$8.28	$14.94	$37.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.59 / $31.67 / $97.96	Professional	TC	$21.59	$31.67	$97.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.42 / $77.98 / $77.98	Professional		$35.42	$77.98	$77.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $21.55 / $21.55	Professional	26	$9.78	$21.55	$21.55
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.63 / $56.45 / $56.45	Professional	TC	$25.63	$56.45	$56.45
United Facility/Professional Professional Modifier Low / Median / High Price $27.41 / $58.30 / $98.83	Professional		$27.41	$58.30	$98.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $10.47 / $27.30	Professional	26	$8.52	$10.47	$27.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.03 / $26.46 / $71.53	Professional	TC	$18.03	$26.46	$71.53