Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.06 / $224.48 / $484.62	Facility		$53.06	$224.48	$484.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.59 / $23.20 / $69.15	Facility	26	$9.59	$23.20	$69.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $83.60 / $210.14 / $448.96	Facility	TC	$83.60	$210.14	$448.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.51 / $41.81 / $72.80	Professional		$11.51	$41.81	$72.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.23 / $9.86 / $23.20	Professional	26	$9.23	$9.86	$23.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.60 / $35.88 / $86.82	Professional	TC	$29.60	$35.88	$86.82
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $45.50 / $51.56 / $99.56	Professional		$45.50	$51.56	$99.56
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.37 / $12.63 / $13.77	Professional	26	$11.37	$12.63	$13.77
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $32.86 / $34.67 / $40.96	Professional	TC	$32.86	$34.67	$40.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.70 / $289.69 / $729.07	Facility		$172.70	$289.69	$729.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.86 / $60.25 / $194.17	Professional		$38.86	$60.25	$194.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.10 / $15.53 / $40.86	Professional	26	$9.10	$15.53	$40.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.84 / $43.71 / $153.30	Professional	TC	$29.84	$43.71	$153.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.45 / $113.30 / $113.30	Professional		$51.45	$113.30	$113.30
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $23.78 / $23.78	Professional	26	$10.80	$23.78	$23.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $40.65 / $89.52 / $89.52	Professional	TC	$40.65	$89.52	$89.52
United Facility/Professional Professional Modifier Low / Median / High Price $34.63 / $54.64 / $143.57	Professional		$34.63	$54.64	$143.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $15.31 / $30.14	Professional	26	$9.36	$15.31	$30.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.79 / $41.88 / $113.43	Professional	TC	$25.79	$41.88	$113.43