Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.34 / $115.84 / $258.62	Facility	26	$84.34	$115.84	$258.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.59 / $127.37 / $260.81	Professional		$117.59	$127.37	$260.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.88 / $39.63 / $87.60	Professional	26	$34.88	$39.63	$87.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $58.80 / $63.69 / $63.69	Professional	52	$58.80	$63.69	$63.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.71 / $91.17 / $204.25	Professional	TC	$82.71	$91.17	$204.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $182.96 / $196.52 / $701.95	Professional		$182.96	$196.52	$701.95
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $52.51 / $59.75 / $98.59	Professional	26	$52.51	$59.75	$98.59
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $123.08 / $136.77 / $225.67	Professional	TC	$123.08	$136.77	$225.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.89 / $278.00 / $634.82	Professional		$173.89	$278.00	$634.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.33 / $63.43 / $164.80	Professional	26	$34.33	$63.43	$164.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.72 / $214.92 / $434.89	Professional	TC	$123.72	$214.92	$434.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.29 / $309.93 / $309.93	Professional		$139.29	$309.93	$309.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.76 / $88.95 / $88.95	Professional	26	$40.76	$88.95	$88.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $98.52 / $220.97 / $220.97	Professional	TC	$98.52	$220.97	$220.97
United Facility/Professional Professional Modifier Low / Median / High Price $116.46 / $217.00 / $505.90	Professional		$116.46	$217.00	$505.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.65 / $50.24 / $135.01	Professional	26	$35.65	$50.24	$135.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.28 / $168.89 / $335.41	Professional	TC	$94.28	$168.89	$335.41