Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.87 / $215.53 / $467.84	Facility		$79.87	$215.53	$467.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.22 / $20.56 / $52.01	Facility	26	$7.22	$20.56	$52.01
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $62.92 / $210.14 / $467.84	Facility	TC	$62.92	$210.14	$467.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.02 / $30.60 / $80.39	Professional		$9.02	$30.60	$80.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $8.55 / $18.66	Professional	26	$6.95	$8.55	$18.66
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.29 / $16.61 / $16.61	Professional	52	$15.29	$16.61	$16.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.05 / $26.00 / $62.92	Professional	TC	$22.05	$26.00	$62.92
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $34.61 / $39.71 / $83.49	Professional		$34.61	$39.71	$83.49
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $10.56 / $17.13	Professional	26	$9.50	$10.56	$17.13
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $24.13 / $29.10 / $39.24	Professional	TC	$24.13	$29.10	$39.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.35 / $206.83 / $729.07	Facility		$121.35	$206.83	$729.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.52 / $44.54 / $141.51	Professional		$27.52	$44.54	$141.51
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 $19.80 / $31.18 / $110.73	Professional	TC	$19.80	$31.18	$110.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.68 / $81.56 / $81.56	Professional		$36.68	$81.56	$81.56
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 $28.57 / $63.70 / $63.70	Professional	TC	$28.57	$63.70	$63.70
United Facility/Professional Professional Modifier Low / Median / High Price $22.81 / $48.09 / $103.36	Professional		$22.81	$48.09	$103.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.60 / $11.52 / $22.67	Professional	26	$6.60	$11.52	$22.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.38 / $59.72 / $80.69	Professional	TC	$19.38	$59.72	$80.69