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 Professional Modifier Low / Median / High Price $400.00 / $425.00 / $509.00	Professional		$400.00	$425.00	$509.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.28 / $118.59 / $161.00	Professional	26	$83.28	$118.59	$161.00
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 / $342.84	Professional	TC	$281.41	$299.00	$342.84
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $309.54 / $312.73 / $1,515.76	Professional		$309.54	$312.73	$1,515.76
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $75.43 / $83.40 / $107.28	Professional	26	$75.43	$83.40	$107.28
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $226.14 / $232.07 / $382.92	Professional	TC	$226.14	$232.07	$382.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.11 / $570.92 / $938.28	Professional		$266.11	$570.92	$938.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.25 / $103.04 / $219.41	Professional	26	$59.25	$103.04	$219.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $175.93 / $431.97 / $764.03	Professional	TC	$175.93	$431.97	$764.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $206.25 / $460.57 / $460.57	Professional		$206.25	$460.57	$460.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $70.37 / $154.12 / $154.12	Professional	26	$70.37	$154.12	$154.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $135.88 / $306.45 / $306.45	Professional	TC	$135.88	$306.45	$306.45
United Facility/Professional Professional Modifier Low / Median / High Price $198.46 / $364.38 / $709.51	Professional		$198.46	$364.38	$709.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.79 / $80.30 / $237.42	Professional	26	$61.79	$80.30	$237.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.02 / $296.70 / $472.09	Professional	TC	$141.02	$296.70	$472.09