Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.21 / $289.88 / $786.25	Facility		$125.21	$289.88	$786.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.28 / $69.19 / $170.27	Facility	26	$24.28	$69.19	$170.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.91 / $107.88 / $190.41	Professional		$67.91	$107.88	$190.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.45 / $24.55 / $58.75	Professional	26	$23.45	$24.55	$58.75
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $49.65 / $53.94 / $53.94	Professional	52	$49.65	$53.94	$53.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.34 / $83.60 / $143.18	Professional	TC	$79.34	$83.60	$143.18
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $134.37 / $134.37 / $241.47	Professional		$134.37	$134.37	$241.47
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $29.71 / $29.71 / $57.57	Professional	26	$29.71	$29.71	$57.57
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $104.66 / $104.66 / $118.75	Professional	TC	$104.66	$104.66	$118.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $385.87 / $659.88 / $896.90	Facility		$385.87	$659.88	$896.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.73 / $139.18 / $353.54	Professional		$95.73	$139.18	$353.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.63 / $32.33 / $82.43	Professional	26	$22.63	$32.33	$82.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.01 / $105.98 / $271.11	Professional	TC	$65.01	$105.98	$271.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.98 / $261.79 / $261.79	Professional		$123.98	$261.79	$261.79
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.38 / $58.56 / $58.56	Professional	26	$28.38	$58.56	$58.56
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $95.61 / $203.23 / $203.23	Professional	TC	$95.61	$203.23	$203.23
United Facility/Professional Professional Modifier Low / Median / High Price $90.59 / $168.84 / $360.36	Professional		$90.59	$168.84	$360.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.48 / $28.87 / $80.61	Professional	26	$21.48	$28.87	$80.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.06 / $120.11 / $294.47	Professional	TC	$73.06	$120.11	$294.47