Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.93 / $102.64 / $240.77	Facility	26	$39.93	$102.64	$240.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.42 / $169.16 / $224.23	Professional		$85.42	$169.16	$224.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.93 / $57.79 / $83.93	Professional	26	$39.93	$57.79	$83.93
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $42.71 / $44.73 / $85.32	Professional	52	$42.71	$44.73	$85.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.29 / $112.65 / $126.14	Professional	TC	$44.29	$112.65	$126.14
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $118.53 / $131.69 / $412.57	Professional		$118.53	$131.69	$412.57
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $46.51 / $59.80 / $66.67	Professional	26	$46.51	$59.80	$66.67
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $60.48 / $71.90 / $118.64	Professional	TC	$60.48	$71.90	$118.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.54 / $248.62 / $321.08	Professional		$107.54	$248.62	$321.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.91 / $104.59 / $127.33	Professional	26	$45.91	$104.59	$127.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.63 / $141.51 / $193.75	Professional	TC	$61.63	$141.51	$193.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.59 / $219.67 / $219.67	Professional		$101.59	$219.67	$219.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $43.37 / $95.50 / $95.50	Professional	26	$43.37	$95.50	$95.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $58.23 / $124.18 / $124.18	Professional	TC	$58.23	$124.18	$124.18
United Facility/Professional Professional Modifier Low / Median / High Price $111.78 / $245.15 / $415.71	Professional		$111.78	$245.15	$415.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.56 / $76.48 / $140.76	Professional	26	$40.56	$76.48	$140.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.22 / $157.25 / $211.00	Professional	TC	$71.22	$157.25	$211.00