Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.65 / $203.95 / $517.65	Facility		$82.65	$203.95	$517.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.47 / $21.38 / $54.08	Facility	26	$17.47	$21.38	$54.08
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $68.51 / $224.48 / $493.15	Facility	TC	$68.51	$224.48	$493.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.66 / $35.81 / $67.03	Professional		$18.66	$35.81	$67.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $7.78 / $18.66	Professional	26	$7.23	$7.78	$18.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.51 / $28.31 / $68.51	Professional	TC	$24.51	$28.31	$68.51
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $32.31 / $39.53 / $84.61	Professional		$32.31	$39.53	$84.61
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.38 / $9.31 / $10.15	Professional	26	$8.38	$9.31	$10.15
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $24.03 / $26.96 / $32.09	Professional	TC	$24.03	$26.96	$32.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.35 / $211.34 / $729.07	Facility		$135.35	$211.34	$729.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.08 / $44.83 / $151.22	Professional		$30.08	$44.83	$151.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.11 / $12.13 / $31.98	Professional	26	$7.11	$12.13	$31.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.36 / $31.84 / $119.24	Professional	TC	$22.36	$31.84	$119.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.31 / $88.75 / $88.75	Professional		$40.31	$88.75	$88.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $18.60 / $18.60	Professional	26	$8.44	$18.60	$18.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.86 / $70.15 / $70.15	Professional	TC	$31.86	$70.15	$70.15
United Facility/Professional Professional Modifier Low / Median / High Price $25.65 / $38.46 / $112.45	Professional		$25.65	$38.46	$112.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $20.32 / $23.57	Professional	26	$6.61	$20.32	$23.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.09 / $38.61 / $88.88	Professional	TC	$19.09	$38.61	$88.88