Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $152.87 / $257.85 / $411.69	Facility	26	$152.87	$257.85	$411.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $244.35 / $400.00 / $475.00	Professional		$244.35	$400.00	$475.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.59 / $126.00 / $161.00	Professional	26	$118.59	$126.00	$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 / $360.20	Professional	TC	$281.41	$299.00	$360.20
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $334.91 / $337.57 / $1,463.69	Professional		$334.91	$337.57	$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 $258.29 / $263.36 / $434.54	Professional	TC	$258.29	$263.36	$434.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.87 / $568.70 / $952.97	Professional		$275.87	$568.70	$952.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.16 / $94.27 / $269.45	Professional	26	$54.16	$94.27	$269.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $200.91 / $454.13 / $736.66	Professional	TC	$200.91	$454.13	$736.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $213.98 / $255.97 / $491.61	Professional		$213.98	$255.97	$491.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $64.31 / $74.47 / $141.60	Professional	26	$64.31	$74.47	$141.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $149.47 / $181.50 / $350.01	Professional	TC	$149.47	$181.50	$350.01
United Facility/Professional Professional Modifier Low / Median / High Price $220.45 / $330.67 / $757.33	Professional		$220.45	$330.67	$757.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.16 / $61.08 / $218.14	Professional	26	$26.16	$61.08	$218.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.37 / $206.39 / $539.19	Professional	TC	$159.37	$206.39	$539.19