Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $77.62 / $229.09	Facility	26	$32.36	$77.62	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $363.08	Professional		$104.71	$134.90	$363.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $42.66 / $117.49	Professional	26	$30.20	$42.66	$117.49
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.38 / $48.98 / $128.82	Professional	52	$17.38	$48.98	$128.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $93.33 / $245.47	Professional	TC	$77.62	$93.33	$245.47
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $144.54 / $309.03	Professional		$107.15	$144.54	$309.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $37.15 / $41.69	Professional	26	$34.67	$37.15	$41.69
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $95.50 / $104.71	Professional	TC	$95.50	$95.50	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $162.18 / $371.54	Professional		$114.82	$162.18	$371.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $43.65 / $95.50	Professional	26	$30.90	$43.65	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $123.03 / $263.03	Professional	TC	$85.11	$123.03	$263.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $144.54 / $302.00	Professional		$134.90	$144.54	$302.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $38.02 / $79.43	Professional	26	$36.31	$38.02	$79.43
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $107.15 / $223.87	Professional	TC	$97.72	$107.15	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $165.96 / $457.09	Professional		$114.82	$165.96	$457.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $45.71 / $117.49	Professional	26	$30.20	$45.71	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $123.03 / $331.13	Professional	TC	$85.11	$123.03	$331.13