Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $452.16 / $878.08	Facility	26	$118.59	$452.16	$878.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $425.00 / $475.00	Professional		$400.00	$425.00	$475.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.59 / $126.00 / $233.49	Professional	26	$118.59	$126.00	$233.49
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 / $335.00	Professional	TC	$281.41	$299.00	$335.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $522.04 / $534.91 / $3,203.64	Professional		$522.04	$534.91	$3,203.64
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $111.18 / $128.68 / $164.29	Professional	26	$111.18	$128.68	$164.29
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $393.38 / $411.39 / $678.79	Professional	TC	$393.38	$411.39	$678.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $430.39 / $999.67 / $1,768.36	Professional		$430.39	$999.67	$1,768.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.86 / $157.99 / $335.35	Professional	26	$91.86	$157.99	$335.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $306.00 / $796.24 / $1,250.93	Professional	TC	$306.00	$796.24	$1,250.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $346.05 / $770.86 / $770.86	Professional		$346.05	$770.86	$770.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $109.08 / $237.79 / $237.79	Professional	26	$109.08	$237.79	$237.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $236.97 / $533.08 / $533.08	Professional	TC	$236.97	$533.08	$533.08
United Facility/Professional Professional Modifier Low / Median / High Price $350.88 / $526.32 / $1,187.52	Professional		$350.88	$526.32	$1,187.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.87 / $126.13 / $366.31	Professional	26	$45.87	$126.13	$366.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $247.50 / $438.88 / $821.21	Professional	TC	$247.50	$438.88	$821.21