Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $147.91 / $602.56	Facility		$58.88	$147.91	$602.56
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $19.05 / $56.23	Facility	26	$7.08	$19.05	$56.23
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $64.57 / $190.55	Facility	TC	$25.70	$64.57	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $31.62 / $91.20	Professional		$8.51	$31.62	$91.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.23 / $44.67	Professional	26	$7.08	$10.23	$44.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $141.25 / $169.82 / $323.59	Professional	50	$141.25	$169.82	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.12 / $60.26	Professional	TC	$19.05	$25.12	$60.26
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $35.48 / $109.65	Professional		$9.33	$35.48	$109.65
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.12 / $12.30	Professional	26	$7.76	$9.12	$12.30
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $30.90 / $33.88	Professional	TC	$26.30	$30.90	$33.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $223.87 / $223.87	Facility		$125.89	$223.87	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $38.90 / $102.33	Professional		$28.84	$38.90	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.96 / $23.44	Professional	26	$7.41	$10.96	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $27.54 / $77.62	Professional	TC	$20.89	$27.54	$77.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $45.71 / $85.11	Professional		$38.02	$45.71	$85.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $10.47 / $19.50	Professional	26	$8.91	$10.47	$19.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $34.67 / $64.57	Professional	TC	$28.84	$34.67	$64.57
United Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $416.87 / $489.78	Facility		$363.08	$416.87	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $41.69 / $107.15	Professional		$26.92	$41.69	$107.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.96 / $24.55	Professional	26	$7.41	$10.96	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $30.90 / $83.18	Professional	TC	$19.50	$30.90	$83.18