Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.72 / $140.72 / $140.72	Facility		$140.72	$140.72	$140.72
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.58 / $222.66 / $522.27	Facility	26	$72.58	$222.66	$522.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.24 / $140.72 / $235.93	Professional		$132.24	$140.72	$235.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $70.83 / $72.58	Professional	26	$48.86	$70.83	$72.58
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $66.36 / $70.36 / $70.36	Professional	52	$66.36	$70.36	$70.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.88 / $68.14 / $184.12	Professional	TC	$61.88	$68.14	$184.12
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $180.73 / $181.82 / $1,261.44	Professional		$180.73	$181.82	$1,261.44
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $67.53 / $81.78 / $119.47	Professional	26	$67.53	$81.78	$119.47
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $96.11 / $106.79 / $176.20	Professional	TC	$96.11	$106.79	$176.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $314.27 / $541.98 / $24,998.62	Facility		$314.27	$541.98	$24,998.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.69 / $366.19 / $713.19	Professional		$130.69	$366.19	$713.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.96 / $85.87 / $311.08	Professional	26	$55.96	$85.87	$311.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.30 / $197.76 / $572.54	Professional	TC	$62.30	$197.76	$572.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $155.19 / $179.71 / $346.56	Professional		$155.19	$179.71	$346.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.23 / $94.05 / $179.63	Professional	26	$81.23	$94.05	$179.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $73.98 / $85.66 / $166.93	Professional	TC	$73.98	$85.66	$166.93
United Facility/Professional Professional Modifier Low / Median / High Price $130.63 / $232.34 / $439.13	Professional		$130.63	$232.34	$439.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.18 / $117.05 / $227.61	Professional	26	$45.18	$117.05	$227.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.67 / $192.83 / $301.62	Professional	TC	$78.67	$192.83	$301.62