Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.60 / $151.78 / $244.80	Facility		$24.60	$151.78	$244.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.47 / $48.59 / $59.34	Facility	26	$25.47	$48.59	$59.34
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $42.33 / $283.77 / $561.89	Facility	TC	$42.33	$283.77	$561.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $47.45 / $75.25	Professional		$40.65	$47.45	$75.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.01 / $22.50 / $25.47	Professional	26	$22.01	$22.50	$25.47
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $20.50 / $23.73 / $24.48	Professional	52	$20.50	$23.73	$24.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $21.98 / $53.22	Professional	TC	$18.48	$21.98	$53.22
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $43.43 / $48.25 / $210.89	Professional		$43.43	$48.25	$210.89
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $16.14 / $23.59 / $25.71	Professional	26	$16.14	$23.59	$25.71
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.81 / $24.66 / $32.79	Professional	TC	$21.81	$24.66	$32.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.19 / $92.66 / $153.46	Professional		$33.19	$92.66	$153.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.11 / $28.18 / $58.27	Professional	26	$16.11	$28.18	$58.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.50 / $52.48 / $90.21	Professional	TC	$14.50	$52.48	$90.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $44.72 / $85.84	Professional		$38.61	$44.72	$85.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.68 / $23.95 / $45.53	Professional	26	$20.68	$23.95	$45.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $17.95 / $20.78 / $40.31	Professional	TC	$17.95	$20.78	$40.31
United Facility/Professional Professional Modifier Low / Median / High Price $41.25 / $101.71 / $191.70	Professional		$41.25	$101.71	$191.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $46.41 / $57.26	Professional	26	$17.98	$46.41	$57.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.27 / $46.35 / $79.66	Professional	TC	$18.27	$46.35	$79.66