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 / $443.90	Facility	26	$118.59	$276.31	$443.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $425.00 / $512.00	Professional		$400.00	$425.00	$512.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.00 / $126.00 / $155.31	Professional	26	$110.00	$126.00	$155.31
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 / $360.20	Professional	TC	$281.41	$299.00	$360.20
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $400.65 / $412.56 / $1,484.73	Professional		$400.65	$412.56	$1,484.73
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $70.84 / $79.51 / $86.67	Professional	26	$70.84	$79.51	$86.67
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $299.74 / $333.05 / $418.80	Professional	TC	$299.74	$333.05	$418.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $325.80 / $584.92 / $1,094.89	Professional		$325.80	$584.92	$1,094.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.40 / $101.08 / $214.43	Professional	26	$58.40	$101.08	$214.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $261.52 / $484.97 / $890.82	Professional	TC	$261.52	$484.97	$890.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $248.08 / $556.74 / $556.74	Professional		$248.08	$556.74	$556.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.34 / $152.68 / $152.68	Professional	26	$69.34	$152.68	$152.68
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $178.73 / $404.04 / $404.04	Professional	TC	$178.73	$404.04	$404.04
United Facility/Professional Professional Modifier Low / Median / High Price $235.50 / $385.43 / $932.07	Professional		$235.50	$385.43	$932.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.64 / $170.43 / $235.20	Professional	26	$56.64	$170.43	$235.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.75 / $345.95 / $761.64	Professional	TC	$190.75	$345.95	$761.64