Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.50 / $86.25 / $287.45	Facility		$70.50	$86.25	$287.45
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 $53.68 / $65.66 / $578.20	Facility	TC	$53.68	$65.66	$578.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.20 / $27.89 / $73.22	Professional		$21.20	$27.89	$73.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $7.41 / $17.47	Professional	26	$6.95	$7.41	$17.47
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.95 / $15.13 / $15.13	Professional	52	$13.95	$15.13	$15.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.28 / $23.04 / $55.75	Professional	TC	$20.28	$23.04	$55.75
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.16 / $35.14 / $78.08	Professional		$30.16	$35.14	$78.08
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.06 / $8.94 / $9.76	Professional	26	$8.06	$8.94	$9.76
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.25 / $23.62 / $26.19	Professional	TC	$21.25	$23.62	$26.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.90 / $170.46 / $896.90	Facility		$108.90	$170.46	$896.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.06 / $38.14 / $128.74	Professional		$26.06	$38.14	$128.74
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 $18.60 / $25.64 / $97.96	Professional	TC	$18.60	$25.64	$97.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.75 / $75.13 / $75.13	Professional		$33.75	$75.13	$75.13
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 $25.63 / $57.24 / $57.24	Professional	TC	$25.63	$57.24	$57.24
United Facility/Professional Professional Modifier Low / Median / High Price $22.12 / $30.68 / $95.20	Professional		$22.12	$30.68	$95.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.60 / $22.67	Professional	26	$6.03	$9.60	$22.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.87 / $48.95 / $72.53	Professional	TC	$16.87	$48.95	$72.53