Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $229.09 / $691.83	Facility		$91.20	$229.09	$691.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $22.91 / $58.88	Facility	26	$7.94	$22.91	$58.88
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.90 / $89.13 / $223.87	Facility	TC	$30.90	$89.13	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $37.15 / $114.82	Professional		$9.12	$37.15	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $19.05 / $48.98	Professional	26	$7.24	$19.05	$48.98
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.48 / $107.15 / $234.42	Professional	50	$35.48	$107.15	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $40.74 / $91.20	Professional	TC	$23.99	$40.74	$91.20
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $41.69 / $131.83	Professional		$9.55	$41.69	$131.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $8.91 / $10.96	Professional	26	$8.51	$8.91	$10.96
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $33.88 / $48.98	Professional	TC	$31.62	$33.88	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $251.19 / $263.03	Facility		$147.91	$251.19	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $42.66 / $117.49	Professional		$32.36	$42.66	$117.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.96 / $23.99	Professional	26	$7.76	$10.96	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.90 / $79.43	Professional	TC	$22.91	$30.90	$79.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $53.70 / $97.72	Professional		$45.71	$53.70	$97.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $11.22 / $19.95	Professional	26	$9.77	$11.22	$19.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $42.66 / $77.62	Professional	TC	$35.48	$42.66	$77.62
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 $28.18 / $47.86 / $123.03	Professional		$28.18	$47.86	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $11.48 / $25.70	Professional	26	$7.24	$11.48	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $36.31 / $97.72	Professional	TC	$21.38	$36.31	$97.72