Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $446.68 / $933.25	Facility		$95.50	$446.68	$933.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $70.79 / $208.93	Facility	26	$28.84	$70.79	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $87.10 / $213.80	Professional		$36.31	$87.10	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $56.23 / $131.83	Professional	26	$28.18	$56.23	$131.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.98 / $144.54 / $295.12	Professional	50	$48.98	$144.54	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $53.70 / $138.04	Professional	TC	$42.66	$53.70	$138.04
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $95.50 / $263.03	Professional		$60.26	$95.50	$263.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $34.67 / $45.71	Professional	26	$30.90	$34.67	$45.71
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $56.23 / $91.20	Professional	TC	$53.70	$56.23	$91.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $436.52 / $524.81	Facility		$245.47	$436.52	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $104.71 / $204.17	Professional		$69.18	$104.71	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $38.90 / $74.13	Professional	26	$25.70	$38.90	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $64.57 / $128.82	Professional	TC	$42.66	$64.57	$128.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $95.50 / $199.53	Professional		$89.13	$95.50	$199.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $33.88 / $70.79	Professional	26	$32.36	$33.88	$70.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $61.66 / $128.82	Professional	TC	$56.23	$61.66	$128.82
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 $75.86 / $89.13 / $257.04	Professional		$75.86	$89.13	$257.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $34.67 / $91.20	Professional	26	$28.18	$34.67	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $54.95 / $165.96	Professional	TC	$46.77	$54.95	$165.96