Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.91 / $147.57 / $433.50	Facility		$65.91	$147.57	$433.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.22 / $20.56 / $52.01	Facility	26	$7.22	$20.56	$52.01
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $49.09 / $154.18 / $233.92	Facility	TC	$49.09	$154.18	$233.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.26 / $28.29 / $68.45	Professional		$22.26	$28.29	$68.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $7.22 / $16.28	Professional	26	$6.95	$7.22	$16.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.16 / $21.07 / $50.98	Professional	TC	$19.16	$21.07	$50.98
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.62 / $31.73 / $80.45	Professional		$30.62	$31.73	$80.45
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.74 / $8.59 / $9.36	Professional	26	$7.74	$8.59	$9.36
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.82 / $23.14 / $25.22	Professional	TC	$20.82	$23.14	$25.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.56 / $167.55 / $729.07	Facility		$99.56	$167.55	$729.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.03 / $39.70 / $120.23	Professional		$26.03	$39.70	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.84 / $11.05 / $30.77	Professional	26	$6.84	$11.05	$30.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.84 / $27.71 / $89.45	Professional	TC	$18.84	$27.71	$89.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.56 / $69.48 / $69.48	Professional		$31.56	$69.48	$69.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $17.89 / $17.89	Professional	26	$8.11	$17.89	$17.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $51.61 / $51.61	Professional	TC	$23.44	$51.61	$51.61
United Facility/Professional Professional Modifier Low / Median / High Price $22.47 / $33.60 / $88.04	Professional		$22.47	$33.60	$88.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.04 / $11.52 / $22.67	Professional	26	$6.04	$11.52	$22.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.90 / $29.35 / $65.37	Professional	TC	$15.90	$29.35	$65.37