Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $257.85 / $411.69	Facility	26	$118.59	$257.85	$411.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $244.71 / $400.00 / $475.00	Professional		$244.71	$400.00	$475.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.59 / $126.00 / $143.57	Professional	26	$118.59	$126.00	$143.57
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 $335.51 / $337.04 / $1,463.69	Professional		$335.51	$337.04	$1,463.69
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $66.79 / $76.63 / $98.70	Professional	26	$66.79	$76.63	$98.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $258.89 / $262.83 / $433.67	Professional	TC	$258.89	$262.83	$433.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.33 / $568.70 / $954.52	Professional		$276.33	$568.70	$954.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.16 / $94.27 / $200.64	Professional	26	$54.16	$94.27	$200.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $201.38 / $454.13 / $736.66	Professional	TC	$201.38	$454.13	$736.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $221.44 / $492.42 / $492.42	Professional		$221.44	$492.42	$492.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $64.31 / $141.60 / $141.60	Professional	26	$64.31	$141.60	$141.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $157.12 / $350.82 / $350.82	Professional	TC	$157.12	$350.82	$350.82
United Facility/Professional Professional Modifier Low / Median / High Price $221.54 / $270.31 / $758.58	Professional		$221.54	$270.31	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.97 / $93.26 / $218.13	Professional	26	$56.97	$93.26	$218.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.37 / $239.06 / $540.45	Professional	TC	$159.37	$239.06	$540.45