Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $85.11 / $426.58	Facility		$74.13	$85.11	$426.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $21.38 / $53.70	Facility	26	$7.08	$21.38	$53.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.99 / $69.18 / $169.82	Facility	TC	$23.99	$69.18	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $33.11 / $93.33	Professional		$25.12	$33.11	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.22 / $28.84	Professional	26	$7.08	$11.22	$28.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $23.99 / $51.29	Professional	TC	$16.98	$23.99	$51.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $33.11 / $114.82	Professional		$8.91	$33.11	$114.82
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $7.94 / $9.33	Professional	26	$7.94	$7.94	$9.33
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $25.70 / $30.90	Professional	TC	$22.39	$25.70	$30.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $186.21 / $199.53	Facility		$114.82	$186.21	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $35.48 / $93.33	Professional		$26.92	$35.48	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.00 / $22.39	Professional	26	$7.08	$10.00	$22.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $25.70 / $60.26	Professional	TC	$19.50	$25.70	$60.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $40.74 / $77.62	Professional		$33.88	$40.74	$77.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.00 / $18.62	Professional	26	$8.71	$10.00	$18.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $30.90 / $58.88	Professional	TC	$25.70	$30.90	$58.88
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 $23.99 / $38.02 / $97.72	Professional		$23.99	$38.02	$97.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $10.47 / $23.44	Professional	26	$6.61	$10.47	$23.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $27.54 / $74.13	Professional	TC	$17.38	$27.54	$74.13