Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.49 / $316.31 / $641.84	Facility		$31.49	$316.31	$641.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.12 / $54.60 / $178.91	Facility	26	$20.12	$54.60	$178.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.34 / $153.05 / $245.73	Professional		$121.34	$153.05	$245.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.12 / $20.12 / $31.95	Professional	26	$20.12	$20.12	$31.95
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $60.67 / $65.36 / $65.36	Professional	52	$60.67	$65.36	$65.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $110.59 / $120.48 / $188.12	Professional	TC	$110.59	$120.48	$188.12
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $164.07 / $164.07 / $505.51	Professional		$164.07	$164.07	$505.51
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $22.35 / $22.35 / $44.40	Professional	26	$22.35	$22.35	$44.40
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $141.72 / $141.72 / $218.22	Professional	TC	$141.72	$141.72	$218.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $507.21 / $856.19 / $1,220.40	Facility		$507.21	$856.19	$1,220.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.09 / $190.03 / $399.14	Professional		$130.09	$190.03	$399.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.44 / $26.87 / $62.02	Professional	26	$20.44	$26.87	$62.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $110.27 / $166.38 / $337.12	Professional	TC	$110.27	$166.38	$337.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $135.40 / $162.76 / $311.10	Professional		$135.40	$162.76	$311.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.50 / $24.52 / $47.40	Professional	26	$21.50	$24.52	$47.40
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $113.90 / $138.24 / $263.70	Professional	TC	$113.90	$138.24	$263.70
United Facility/Professional Professional Modifier Low / Median / High Price $126.23 / $177.44 / $384.29	Professional		$126.23	$177.44	$384.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.02 / $27.27 / $59.42	Professional	26	$18.02	$27.27	$59.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.40 / $154.62 / $324.87	Professional	TC	$95.40	$154.62	$324.87