Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.54 / $233.92 / $467.84	Facility		$81.54	$233.92	$467.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.47 / $21.38 / $54.08	Facility	26	$17.47	$21.38	$54.08
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $68.51 / $224.48 / $467.84	Facility	TC	$68.51	$224.48	$467.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.30 / $35.81 / $86.66	Professional		$17.30	$35.81	$86.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $7.78 / $18.66	Professional	26	$7.23	$7.78	$18.66
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.48 / $17.91 / $17.91	Professional	52	$16.48	$17.91	$17.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.87 / $28.31 / $68.51	Professional	TC	$24.87	$28.31	$68.51
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $36.92 / $40.67 / $84.61	Professional		$36.92	$40.67	$84.61
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.38 / $9.31 / $15.36	Professional	26	$8.38	$9.31	$15.36
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.61 / $31.36 / $40.00	Professional	TC	$27.61	$31.36	$40.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.69 / $218.16 / $729.07	Facility		$130.69	$218.16	$729.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.29 / $45.35 / $152.65	Professional		$29.29	$45.35	$152.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.11 / $12.13 / $31.98	Professional	26	$7.11	$12.13	$31.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.36 / $32.35 / $120.66	Professional	TC	$22.36	$32.35	$120.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.21 / $87.14 / $87.14	Professional		$39.21	$87.14	$87.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $18.60 / $18.60	Professional	26	$8.44	$18.60	$18.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.76 / $68.54 / $68.54	Professional	TC	$30.76	$68.54	$68.54
United Facility/Professional Professional Modifier Low / Median / High Price $25.71 / $38.46 / $110.42	Professional		$25.71	$38.46	$110.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $11.98 / $23.57	Professional	26	$6.61	$11.98	$23.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.28 / $38.61 / $86.85	Professional	TC	$19.28	$38.61	$86.85