Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $186.21 / $524.81	Facility		$93.33	$186.21	$524.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $23.44 / $69.18	Facility	26	$8.91	$23.44	$69.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $79.43 / $213.80	Facility	TC	$30.20	$79.43	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $42.66 / $100.00	Professional		$32.36	$42.66	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.02 / $31.62	Professional	26	$8.71	$12.02	$31.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $50.12 / $186.21 / $204.17	Professional	50	$50.12	$186.21	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $28.84 / $70.79	Professional	TC	$22.91	$28.84	$70.79
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $46.77 / $151.36	Professional		$35.48	$46.77	$151.36
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $11.22 / $13.18	Professional	26	$10.23	$11.22	$13.18
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $31.62 / $46.77	Professional	TC	$30.90	$31.62	$46.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $251.19 / $269.15	Facility		$144.54	$251.19	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $46.77 / $117.49	Professional		$33.88	$46.77	$117.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $13.18 / $28.84	Professional	26	$9.12	$13.18	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $33.88 / $87.10	Professional	TC	$24.55	$33.88	$87.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $53.70 / $97.72	Professional		$44.67	$53.70	$97.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $12.88 / $23.99	Professional	26	$11.22	$12.88	$23.99
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $40.74 / $74.13	Professional	TC	$33.88	$40.74	$74.13
United Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $501.19 / $588.84	Facility		$426.58	$501.19	$588.84
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $47.86 / $123.03	Professional		$33.11	$47.86	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $13.49 / $30.20	Professional	26	$9.12	$13.49	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $35.48 / $93.33	Professional	TC	$23.99	$35.48	$93.33