Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $190.55 / $562.34	Facility		$74.13	$190.55	$562.34
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 / $173.78	Facility	TC	$23.99	$69.18	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $33.11 / $91.20	Professional		$9.12	$33.11	$91.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $16.22 / $42.66	Professional	26	$7.08	$16.22	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.77 / $144.54 / $295.12	Professional	50	$46.77	$144.54	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.92 / $83.18	Professional	TC	$18.62	$26.92	$83.18
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $33.11 / $120.23	Professional		$8.91	$33.11	$120.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $7.94 / $9.77	Professional	26	$7.94	$7.94	$9.77
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $27.54 / $30.90	Professional	TC	$22.39	$27.54	$30.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $204.17 / $213.80	Facility		$114.82	$204.17	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.90 / $93.33	Professional		$26.92	$38.90	$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 $19.95 / $28.18 / $64.57	Professional	TC	$19.95	$28.18	$64.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $41.69 / $77.62	Professional		$35.48	$41.69	$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 $26.30 / $32.36 / $60.26	Professional	TC	$26.30	$32.36	$60.26
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 $28.18 / $37.15 / $100.00	Professional		$28.18	$37.15	$100.00
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 $20.89 / $27.54 / $75.86	Professional	TC	$20.89	$27.54	$75.86