Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.84 / $103.68 / $492.00	Facility		$73.84	$103.68	$492.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.82 / $20.56 / $52.01	Facility	26	$16.82	$20.56	$52.01
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $59.83 / $73.16 / $163.05	Facility	TC	$59.83	$73.16	$163.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.71 / $32.89 / $61.86	Professional		$23.71	$32.89	$61.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $7.66 / $17.47	Professional	26	$6.95	$7.66	$17.47
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.14 / $16.45 / $16.45	Professional	52	$15.14	$16.45	$16.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.76 / $25.68 / $62.14	Professional	TC	$22.76	$25.68	$62.14
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $32.52 / $38.45 / $78.08	Professional		$32.52	$38.45	$78.08
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $10.13 / $11.04	Professional	26	$9.11	$10.13	$11.04
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.49 / $26.37 / $28.77	Professional	TC	$23.49	$26.37	$28.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $119.79 / $197.72 / $729.07	Facility		$119.79	$197.72	$729.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.12 / $41.80 / $140.09	Professional		$27.12	$41.80	$140.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.84 / $11.64 / $30.77	Professional	26	$6.84	$11.64	$30.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.48 / $29.77 / $109.31	Professional	TC	$20.48	$29.77	$109.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.32 / $80.78 / $80.78	Professional		$36.32	$80.78	$80.78
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 $28.20 / $62.89 / $62.89	Professional	TC	$28.20	$62.89	$62.89
United Facility/Professional Professional Modifier Low / Median / High Price $24.88 / $33.20 / $102.36	Professional		$24.88	$33.20	$102.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.00 / $8.66 / $22.67	Professional	26	$7.00	$8.66	$22.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.64 / $35.99 / $79.69	Professional	TC	$17.64	$35.99	$79.69