Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $95.50 / $537.03	Facility		$79.43	$95.50	$537.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $22.91 / $58.88	Facility	26	$7.94	$22.91	$58.88
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.12 / $72.44 / $181.97	Facility	TC	$25.12	$72.44	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $33.88 / $93.33	Professional		$9.12	$33.88	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.79 / $45.71	Professional	26	$7.94	$14.79	$45.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $31.62 / $93.33 / $199.53	Professional	50	$31.62	$93.33	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $33.11 / $83.18	Professional	TC	$19.05	$33.11	$83.18
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $38.90 / $123.03	Professional		$22.91	$38.90	$123.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.55 / $10.47	Professional	26	$8.71	$9.55	$10.47
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $27.54 / $32.36	Professional	TC	$22.39	$27.54	$32.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $186.21 / $213.80	Facility		$120.23	$186.21	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $36.31 / $95.50	Professional		$28.18	$36.31	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.96 / $23.99	Professional	26	$7.76	$10.96	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.30 / $64.57	Professional	TC	$20.42	$26.30	$64.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $45.71 / $83.18	Professional		$38.02	$45.71	$83.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $10.96 / $19.95	Professional	26	$9.33	$10.96	$19.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $34.67 / $63.10	Professional	TC	$28.84	$34.67	$63.10
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 $25.12 / $39.81 / $104.71	Professional		$25.12	$39.81	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $11.48 / $25.70	Professional	26	$7.24	$11.48	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $28.84 / $79.43	Professional	TC	$16.98	$28.84	$79.43