Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $102.33 / $162.18	Facility	26	$38.90	$102.33	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $134.90 / $398.11	Professional		$87.10	$134.90	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $58.88 / $208.93	Professional	26	$39.81	$58.88	$208.93
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $20.42 / $70.79 / $117.49	Professional	52	$20.42	$70.79	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $74.13 / $177.83	Professional	TC	$45.71	$74.13	$177.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $100.00 / $660.69	Professional		$47.86	$100.00	$660.69
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $42.66 / $54.95	Professional	26	$42.66	$42.66	$54.95
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $64.57 / $77.62	Professional	TC	$64.57	$64.57	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $234.42 / $309.03	Professional		$117.49	$234.42	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $91.20 / $125.89	Professional	26	$56.23	$91.20	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $131.83 / $173.78	Professional	TC	$61.66	$131.83	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $128.82 / $288.40	Professional		$112.20	$128.82	$288.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $53.70 / $97.72	Professional	26	$46.77	$53.70	$97.72
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $75.86 / $190.55	Professional	TC	$66.07	$75.86	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $234.42 / $416.87	Professional		$141.25	$234.42	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $89.13 / $134.90	Professional	26	$48.98	$89.13	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $138.04 / $208.93	Professional	TC	$95.50	$138.04	$208.93