Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.81 / $76.83 / $289.26	Facility		$64.81	$76.83	$289.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.22 / $20.56 / $49.64	Facility	26	$7.22	$20.56	$49.64
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $56.75 / $76.83 / $431.06	Facility	TC	$56.75	$76.83	$431.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.04 / $31.58 / $73.58	Professional		$22.04	$31.58	$73.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $7.41 / $17.01	Professional	26	$6.95	$7.41	$17.01
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.55 / $15.79 / $28.69	Professional	52	$14.55	$15.79	$28.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $24.36 / $58.95	Professional	TC	$21.00	$24.36	$58.95
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.24 / $36.25 / $78.08	Professional		$30.24	$36.25	$78.08
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.06 / $8.94 / $9.76	Professional	26	$8.06	$8.94	$9.76
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.27 / $24.99 / $27.30	Professional	TC	$22.27	$24.99	$27.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $113.57 / $193.74 / $729.07	Facility		$113.57	$193.74	$729.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.06 / $42.31 / $132.99	Professional		$26.06	$42.31	$132.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.53 / $11.64 / $29.36	Professional	26	$6.53	$11.64	$29.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.97 / $29.69 / $103.64	Professional	TC	$18.97	$29.69	$103.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.49 / $76.73 / $76.73	Professional		$34.49	$76.73	$76.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $17.07 / $17.07	Professional	26	$7.75	$17.07	$17.07
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.73 / $59.66 / $59.66	Professional	TC	$26.73	$59.66	$59.66
United Facility/Professional Professional Modifier Low / Median / High Price $22.67 / $45.92 / $97.23	Professional		$22.67	$45.92	$97.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.30 / $9.16 / $21.64	Professional	26	$6.30	$9.16	$21.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.98 / $51.35 / $75.59	Professional	TC	$17.98	$51.35	$75.59