Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $93.33 / $588.84	Facility		$63.10	$93.33	$588.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $19.50 / $50.12	Facility	26	$6.03	$19.50	$50.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $64.57 / $169.82	Facility	TC	$22.91	$64.57	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $28.84 / $89.13	Professional		$8.32	$28.84	$89.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $17.38 / $46.77	Professional	26	$6.03	$17.38	$46.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.77 / $128.82 / $275.42	Professional	50	$46.77	$128.82	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.12 / $64.57	Professional	TC	$16.98	$25.12	$64.57
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $32.36 / $112.20	Professional		$8.91	$32.36	$112.20
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $7.41 / $9.33	Professional	26	$7.24	$7.41	$9.33
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $25.12 / $37.15	Professional	TC	$20.42	$25.12	$37.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $194.98 / $199.53	Facility		$112.20	$194.98	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.88 / $91.20	Professional		$25.70	$33.88	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.77 / $20.42	Professional	26	$6.61	$9.77	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $23.99 / $60.26	Professional	TC	$18.62	$23.99	$60.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $39.81 / $75.86	Professional		$33.11	$39.81	$75.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.12 / $16.98	Professional	26	$7.94	$9.12	$16.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $30.90 / $57.54	Professional	TC	$25.70	$30.90	$57.54
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 $21.88 / $37.15 / $95.50	Professional		$21.88	$37.15	$95.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.77 / $21.88	Professional	26	$6.61	$9.77	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $27.54 / $74.13	Professional	TC	$15.49	$27.54	$74.13