Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.04 / $297.74 / $978.10	Facility		$25.04	$297.74	$978.10
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.08 / $88.57 / $224.05	Facility	26	$31.08	$88.57	$224.05
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $141.82 / $283.64 / $709.27	Facility	TC	$141.82	$283.64	$709.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.59 / $114.01 / $242.68	Professional		$96.59	$114.01	$242.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.08 / $32.86 / $75.20	Professional	26	$31.08	$32.86	$75.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $48.30 / $52.24 / $52.24	Professional	52	$48.30	$52.24	$52.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.40 / $80.27 / $126.39	Professional	TC	$73.40	$80.27	$126.39
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $143.32 / $143.78 / $329.29	Professional		$143.32	$143.78	$329.29
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $38.56 / $38.56 / $93.52	Professional	26	$38.56	$38.56	$93.52
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $94.28 / $105.22 / $164.63	Professional	TC	$94.28	$105.22	$164.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $340.74 / $578.70 / $896.90	Facility		$340.74	$578.70	$896.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.01 / $154.37 / $343.98	Professional		$97.01	$154.37	$343.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.47 / $42.55 / $108.17	Professional	26	$29.47	$42.55	$108.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.36 / $106.53 / $245.13	Professional	TC	$66.36	$106.53	$245.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $121.26 / $255.29 / $255.29	Professional		$121.26	$255.29	$255.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.84 / $77.06 / $77.06	Professional	26	$36.84	$77.06	$77.06
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $84.42 / $178.23 / $178.23	Professional	TC	$84.42	$178.23	$178.23
United Facility/Professional Professional Modifier Low / Median / High Price $103.62 / $126.36 / $369.90	Professional		$103.62	$126.36	$369.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.65 / $37.53 / $106.08	Professional	26	$28.65	$37.53	$106.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.09 / $113.71 / $245.33	Professional	TC	$72.09	$113.71	$245.33