Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.49 / $109.89 / $557.46	Facility		$27.49	$109.89	$557.46
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 $70.09 / $276.62 / $465.29	Facility	TC	$70.09	$276.62	$465.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.54 / $38.56 / $89.84	Professional		$35.54	$38.56	$89.84
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 $26.32 / $28.97 / $70.09	Professional	TC	$26.32	$28.97	$70.09
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $39.29 / $45.15 / $107.84	Professional		$39.29	$45.15	$107.84
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.41 / $12.68 / $20.92	Professional	26	$11.41	$12.68	$20.92
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.61 / $30.43 / $46.07	Professional	TC	$26.61	$30.43	$46.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.35 / $228.38 / $896.90	Facility		$135.35	$228.38	$896.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.93 / $50.95 / $164.37	Professional		$35.93	$50.95	$164.37
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 $26.31 / $34.42 / $123.50	Professional	TC	$26.31	$34.42	$123.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $94.74 / $94.74	Professional		$42.66	$94.74	$94.74
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 / $70.95 / $70.95	Professional	TC	$31.86	$70.95	$70.95
United Facility/Professional Professional Modifier Low / Median / High Price $31.41 / $41.89 / $120.05	Professional		$31.41	$41.89	$120.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $15.16 / $30.14	Professional	26	$8.52	$15.16	$30.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.88 / $39.29 / $89.91	Professional	TC	$22.88	$39.29	$89.91