Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.82 / $224.48 / $562.96	Facility		$84.82	$224.48	$562.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.72 / $20.45 / $51.71	Facility	26	$16.72	$20.45	$51.71
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.00 / $224.48 / $561.20	Facility	TC	$26.00	$224.48	$561.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.61 / $33.18 / $80.29	Professional		$8.61	$33.18	$80.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.93 / $7.78 / $18.66	Professional	26	$6.93	$7.78	$18.66
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.28 / $16.59 / $16.59	Professional	52	$15.28	$16.59	$16.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.63 / $26.00 / $62.92	Professional	TC	$23.63	$26.00	$62.92
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $35.04 / $38.04 / $84.61	Professional		$35.04	$38.04	$84.61
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $8.90 / $14.69	Professional	26	$8.01	$8.90	$14.69
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.13 / $29.15 / $40.00	Professional	TC	$26.13	$29.15	$40.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.35 / $197.72 / $729.07	Facility		$121.35	$197.72	$729.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.29 / $42.25 / $142.72	Professional		$29.29	$42.25	$142.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.80 / $11.67 / $30.57	Professional	26	$6.80	$11.67	$30.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.10 / $29.77 / $112.15	Professional	TC	$21.10	$29.77	$112.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.64 / $81.48 / $81.48	Professional		$36.64	$81.48	$81.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.08 / $17.79 / $17.79	Professional	26	$8.08	$17.79	$17.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.57 / $63.70 / $63.70	Professional	TC	$28.57	$63.70	$63.70
United Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $47.44 / $103.26	Professional		$25.37	$47.44	$103.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.60 / $11.45 / $22.54	Professional	26	$6.60	$11.45	$22.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.80 / $24.54 / $80.72	Professional	TC	$18.80	$24.54	$80.72