Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $342.21 / $665.38	Facility	26	$118.59	$342.21	$665.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $400.00 / $546.25	Professional		$400.00	$400.00	$546.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.59 / $118.59 / $176.52	Professional	26	$118.59	$118.59	$176.52
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 / $281.41 / $385.24	Professional	TC	$281.41	$281.41	$385.24
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $447.79 / $456.16 / $1,799.24	Professional		$447.79	$456.16	$1,799.24
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $85.83 / $96.33 / $105.00	Professional	26	$85.83	$96.33	$105.00
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $323.85 / $359.83 / $478.57	Professional	TC	$323.85	$359.83	$478.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $365.22 / $710.15 / $1,277.11	Professional		$365.22	$710.15	$1,277.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.15 / $123.44 / $262.08	Professional	26	$71.15	$123.44	$262.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $269.22 / $575.80 / $991.58	Professional	TC	$269.22	$575.80	$991.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $294.36 / $656.22 / $656.22	Professional		$294.36	$656.22	$656.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $84.49 / $185.24 / $185.24	Professional	26	$84.49	$185.24	$185.24
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $209.86 / $470.98 / $470.98	Professional	TC	$209.86	$470.98	$470.98
United Facility/Professional Professional Modifier Low / Median / High Price $266.58 / $461.97 / $1,010.91	Professional		$266.58	$461.97	$1,010.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.95 / $96.23 / $285.37	Professional	26	$68.95	$96.23	$285.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $171.65 / $325.77 / $725.54	Professional	TC	$171.65	$325.77	$725.54