Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $114.82 / $562.34	Facility		$79.43	$114.82	$562.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $20.42 / $51.29	Facility	26	$7.08	$20.42	$51.29
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $74.13 / $186.21	Facility	TC	$25.70	$74.13	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $33.11 / $97.72	Professional		$8.32	$33.11	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $16.60 / $46.77	Professional	26	$6.03	$16.60	$46.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $85.11 / $295.12	Professional	50	$34.67	$85.11	$295.12
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.30 / $61.66 / $61.66	Professional	52	$26.30	$61.66	$61.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $37.15 / $81.28	Professional	TC	$19.95	$37.15	$81.28
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $38.02 / $112.20	Professional		$9.33	$38.02	$112.20
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $8.32 / $17.78	Professional	26	$7.59	$8.32	$17.78
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $30.20 / $39.81	Professional	TC	$25.70	$30.20	$39.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $199.53 / $218.78	Facility		$120.23	$199.53	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $35.48 / $97.72	Professional		$27.54	$35.48	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $9.77 / $21.38	Professional	26	$6.92	$9.77	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $25.70 / $66.07	Professional	TC	$20.89	$25.70	$66.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $43.65 / $81.28	Professional		$36.31	$43.65	$81.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $9.55 / $17.78	Professional	26	$8.32	$9.55	$17.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $33.88 / $63.10	Professional	TC	$28.18	$33.88	$63.10
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 $25.12 / $39.81 / $102.33	Professional		$25.12	$39.81	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $10.23 / $22.39	Professional	26	$6.61	$10.23	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $30.20 / $81.28	Professional	TC	$18.62	$30.20	$81.28