Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.40 / $219.59 / $240.22	Facility	26	$53.40	$219.59	$240.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.84 / $388.76 / $499.17	Professional		$354.84	$388.76	$499.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.40 / $53.94 / $64.40	Professional	26	$53.40	$53.94	$64.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $177.42 / $194.38 / $243.12	Professional	52	$177.42	$194.38	$243.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $299.45 / $335.36 / $434.76	Professional	TC	$299.45	$335.36	$434.76
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $442.42 / $491.58 / $1,114.33	Professional		$442.42	$491.58	$1,114.33
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $59.87 / $66.52 / $72.51	Professional	26	$59.87	$66.52	$72.51
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $382.55 / $425.06 / $514.90	Professional	TC	$382.55	$425.06	$514.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $475.81 / $917.17 / $1,294.85	Professional		$475.81	$917.17	$1,294.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.43 / $126.69 / $168.48	Professional	26	$61.43	$126.69	$168.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $403.94 / $792.50 / $1,125.01	Professional	TC	$403.94	$792.50	$1,125.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $449.50 / $980.11 / $980.11	Professional		$449.50	$980.11	$980.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.03 / $128.57 / $128.57	Professional	26	$58.03	$128.57	$128.57
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $391.48 / $851.54 / $851.54	Professional	TC	$391.48	$851.54	$851.54
United Facility/Professional Professional Modifier Low / Median / High Price $381.78 / $643.23 / $1,241.16	Professional		$381.78	$643.23	$1,241.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.42 / $112.99 / $164.17	Professional	26	$55.42	$112.99	$164.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $326.39 / $604.39 / $1,078.34	Professional	TC	$326.39	$604.39	$1,078.34