Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.06 / $210.14 / $467.84	Facility		$66.06	$210.14	$467.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.28 / $18.69 / $47.28	Facility	26	$15.28	$18.69	$47.28
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $50.19 / $224.48 / $448.97	Facility	TC	$50.19	$224.48	$448.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.92 / $27.30 / $66.06	Professional		$20.92	$27.30	$66.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.35 / $6.84 / $16.00	Professional	26	$6.35	$6.84	$16.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.61 / $13.65 / $13.65	Professional	52	$12.61	$13.65	$13.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.86 / $20.74 / $50.19	Professional	TC	$18.86	$20.74	$50.19
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.55 / $30.55 / $78.08	Professional		$30.55	$30.55	$78.08
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.32 / $8.14 / $13.43	Professional	26	$7.32	$8.14	$13.43
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.17 / $22.41 / $36.97	Professional	TC	$20.17	$22.41	$36.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.01 / $167.55 / $729.07	Facility		$98.01	$167.55	$729.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.65 / $38.14 / $115.97	Professional		$25.65	$38.14	$115.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.22 / $10.72 / $27.94	Professional	26	$6.22	$10.72	$27.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.13 / $26.67 / $88.03	Professional	TC	$18.13	$26.67	$88.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.46 / $67.87 / $67.87	Professional		$30.46	$67.87	$67.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.39 / $16.26 / $16.26	Professional	26	$7.39	$16.26	$16.26
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.07 / $51.61 / $51.61	Professional	TC	$23.07	$51.61	$51.61
United Facility/Professional Professional Modifier Low / Median / High Price $21.91 / $40.10 / $86.00	Professional		$21.91	$40.10	$86.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.36 / $20.61	Professional	26	$6.03	$10.36	$20.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.48 / $29.35 / $65.39	Professional	TC	$15.48	$29.35	$65.39