Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.62 / $130.38 / $327.47	Facility	26	$106.62	$130.38	$327.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.79 / $131.33 / $255.01	Professional		$121.79	$131.33	$255.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.15 / $46.89 / $110.73	Professional	26	$44.15	$46.89	$110.73
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $60.90 / $65.67 / $73.44	Professional	52	$60.90	$65.67	$73.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.64 / $85.57 / $201.03	Professional	TC	$77.64	$85.57	$201.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $188.86 / $225.75 / $842.51	Professional		$188.86	$225.75	$842.51
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $53.02 / $57.79 / $87.48	Professional	26	$53.02	$57.79	$87.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $122.36 / $172.73 / $285.00	Professional	TC	$122.36	$172.73	$285.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $188.24 / $332.85 / $614.05	Professional		$188.24	$332.85	$614.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.08 / $75.91 / $211.74	Professional	26	$43.08	$75.91	$211.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $118.96 / $253.39 / $404.66	Professional	TC	$118.96	$253.39	$404.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $143.82 / $319.91 / $319.91	Professional		$143.82	$319.91	$319.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.16 / $112.63 / $112.63	Professional	26	$51.16	$112.63	$112.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $92.66 / $207.27 / $207.27	Professional	TC	$92.66	$207.27	$207.27
United Facility/Professional Professional Modifier Low / Median / High Price $126.53 / $226.81 / $485.57	Professional		$126.53	$226.81	$485.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.32 / $62.30 / $170.96	Professional	26	$39.32	$62.30	$170.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.52 / $157.15 / $351.44	Professional	TC	$95.52	$157.15	$351.44