Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.93 / $204.57 / $450.40	Facility	26	$28.93	$204.57	$450.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $425.00 / $509.89	Professional		$400.00	$425.00	$509.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.64 / $126.00 / $158.34	Professional	26	$83.64	$126.00	$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 / $343.73	Professional	TC	$281.41	$299.00	$343.73
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $310.57 / $317.08 / $1,641.93	Professional		$310.57	$317.08	$1,641.93
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $72.59 / $83.83 / $107.28	Professional	26	$72.59	$83.83	$107.28
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $226.74 / $236.43 / $390.11	Professional	TC	$226.74	$236.43	$390.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.54 / $596.72 / $942.45	Professional		$266.54	$596.72	$942.45
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 $176.39 / $455.81 / $764.87	Professional	TC	$176.39	$455.81	$764.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $206.98 / $462.17 / $462.17	Professional		$206.98	$462.17	$462.17
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $70.37 / $154.91 / $154.91	Professional	26	$70.37	$154.91	$154.91
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $136.61 / $307.26 / $307.26	Professional	TC	$136.61	$307.26	$307.26
United Facility/Professional Professional Modifier Low / Median / High Price $208.54 / $359.98 / $711.98	Professional		$208.54	$359.98	$711.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.90 / $80.30 / $238.64	Professional	26	$50.90	$80.30	$238.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.71 / $222.59 / $473.34	Professional	TC	$123.71	$222.59	$473.34