Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $276.31 / $448.10	Facility	26	$118.59	$276.31	$448.10
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $80.00 / $210.88 / $563.61	Facility	53	$80.00	$210.88	$563.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $425.00 / $512.00	Professional		$400.00	$425.00	$512.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.51 / $118.59 / $158.34	Professional	26	$78.51	$118.59	$158.34
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $200.00 / $200.00 / $212.50	Professional	52	$200.00	$200.00	$212.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $299.00 / $356.05	Professional	TC	$281.41	$299.00	$356.05
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $328.79 / $335.42 / $1,499.72	Professional		$328.79	$335.42	$1,499.72
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $72.22 / $83.40 / $106.72	Professional	26	$72.22	$83.40	$106.72
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $248.55 / $252.02 / $410.11	Professional	TC	$248.55	$252.02	$410.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $268.04 / $587.04 / $1,063.06	Professional		$268.04	$587.04	$1,063.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.95 / $103.04 / $217.44	Professional	26	$58.95	$103.04	$217.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $183.79 / $467.83 / $902.57	Professional	TC	$183.79	$467.83	$902.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $212.84 / $474.29 / $474.29	Professional		$212.84	$474.29	$474.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $70.00 / $154.12 / $154.12	Professional	26	$70.00	$154.12	$154.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $142.84 / $320.17 / $320.17	Professional	TC	$142.84	$320.17	$320.17
United Facility/Professional Professional Modifier Low / Median / High Price $214.20 / $321.30 / $730.65	Professional		$214.20	$321.30	$730.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.85 / $83.95 / $237.42	Professional	26	$56.85	$83.95	$237.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.04 / $231.49 / $493.23	Professional	TC	$147.04	$231.49	$493.23