Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $147.91 / $467.74	Facility		$69.18	$147.91	$467.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $19.50 / $50.12	Facility	26	$6.03	$19.50	$50.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.89 / $61.66 / $151.36	Facility	TC	$20.89	$61.66	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $26.92 / $74.13	Professional		$8.32	$26.92	$74.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $15.85 / $39.81	Professional	26	$6.03	$15.85	$39.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.43 / $141.25 / $288.40	Professional	50	$79.43	$141.25	$288.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $20.89 / $60.26	Professional	TC	$15.85	$20.89	$60.26
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $32.36 / $104.71	Professional		$10.96	$32.36	$104.71
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $7.94 / $8.91	Professional	26	$7.24	$7.94	$8.91
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $22.39 / $27.54	Professional	TC	$20.42	$22.39	$27.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $165.96 / $177.83	Facility		$100.00	$165.96	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $32.36 / $85.11	Professional		$23.99	$32.36	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.12 / $20.42	Professional	26	$6.61	$9.12	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $23.44 / $53.70	Professional	TC	$17.78	$23.44	$53.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $37.15 / $69.18	Professional		$30.90	$37.15	$69.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.12 / $16.98	Professional	26	$7.94	$9.12	$16.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $27.54 / $52.48	Professional	TC	$22.91	$27.54	$52.48
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 $22.39 / $34.67 / $87.10	Professional		$22.39	$34.67	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.23 / $21.88	Professional	26	$6.03	$10.23	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $25.12 / $66.07	Professional	TC	$16.22	$25.12	$66.07