Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $302.00 / $1,380.38	Facility		$22.91	$302.00	$1,380.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $50.12 / $85.11	Facility	26	$20.89	$50.12	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $151.36 / $295.12	Professional		$109.65	$151.36	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $26.30 / $67.61	Professional	26	$20.89	$26.30	$67.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $100.00 / $169.82	Professional	TC	$85.11	$100.00	$169.82
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $123.03 / $588.84	Professional		$97.72	$123.03	$588.84
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $22.91 / $26.30	Professional	26	$20.42	$22.91	$26.30
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $102.33 / $117.49	Professional	TC	$91.20	$102.33	$117.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $776.25 / $912.01	Facility		$436.52	$776.25	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $165.96 / $363.08	Professional		$117.49	$165.96	$363.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $26.30 / $48.98	Professional	26	$20.42	$26.30	$48.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $131.83 / $257.04	Professional	TC	$95.50	$131.83	$257.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $134.90 / $281.84	Professional		$125.89	$134.90	$281.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $25.12 / $51.29	Professional	26	$23.99	$25.12	$51.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $109.65 / $229.09	Professional	TC	$100.00	$109.65	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $501.19 / $588.84	Facility		$426.58	$501.19	$588.84
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $346.74	Professional		$112.20	$158.49	$346.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $26.92 / $66.07	Professional	26	$19.50	$26.92	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $134.90 / $281.84	Professional	TC	$89.13	$134.90	$281.84