Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.27 / $224.48 / $574.86	Facility		$91.27	$224.48	$574.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.91 / $23.14 / $58.51	Facility	26	$18.91	$23.14	$58.51
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $75.67 / $210.14 / $538.82	Facility	TC	$75.67	$210.14	$538.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.39 / $39.39 / $95.32	Professional		$19.39	$39.39	$95.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.81 / $8.59 / $21.50	Professional	26	$7.81	$8.59	$21.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $18.11 / $19.70 / $19.70	Professional	52	$18.11	$19.70	$19.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.69 / $31.27 / $75.67	Professional	TC	$27.69	$31.27	$75.67
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $38.64 / $46.30 / $91.73	Professional		$38.64	$46.30	$91.73
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $10.84 / $11.82	Professional	26	$9.66	$10.84	$11.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.98 / $32.52 / $35.45	Professional	TC	$28.98	$32.52	$35.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.80 / $251.35 / $729.07	Facility		$147.80	$251.35	$729.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.76 / $52.05 / $169.46	Professional		$32.76	$52.05	$169.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.70 / $13.09 / $34.61	Professional	26	$7.70	$13.09	$34.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.61 / $36.88 / $134.85	Professional	TC	$24.61	$36.88	$134.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.93 / $97.53 / $97.53	Professional		$43.93	$97.53	$97.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.14 / $20.12 / $20.12	Professional	26	$9.14	$20.12	$20.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $34.79 / $77.41 / $77.41	Professional	TC	$34.79	$77.41	$77.41
United Facility/Professional Professional Modifier Low / Median / High Price $29.47 / $56.88 / $123.58	Professional		$29.47	$56.88	$123.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.89 / $9.74 / $25.50	Professional	26	$7.89	$9.74	$25.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.02 / $43.92 / $98.08	Professional	TC	$23.02	$43.92	$98.08