Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.88 / $165.15 / $309.39	Facility		$70.88	$165.15	$309.39
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.82 / $86.64 / $90.45	Facility	26	$38.82	$86.64	$90.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.68 / $158.06 / $230.00	Professional		$68.68	$158.06	$230.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.82 / $72.42 / $81.34	Professional	26	$38.82	$72.42	$81.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.38 / $71.42 / $148.65	Professional	TC	$29.38	$71.42	$148.65
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $72.51 / $80.56 / $243.03	Professional		$72.51	$80.56	$243.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $37.63 / $44.16 / $90.40	Professional	26	$37.63	$44.16	$90.40
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $31.49 / $34.99 / $60.06	Professional	TC	$31.49	$34.99	$60.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.79 / $226.80 / $405.02	Professional		$76.79	$226.80	$405.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.04 / $102.29 / $173.15	Professional	26	$42.04	$102.29	$173.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.75 / $102.47 / $225.09	Professional	TC	$34.75	$102.47	$225.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.17 / $148.69 / $148.69	Professional		$67.17	$148.69	$148.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.77 / $80.94 / $80.94	Professional	26	$36.77	$80.94	$80.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.39 / $67.73 / $67.73	Professional	TC	$30.39	$67.73	$67.73
United Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $442.00 / $5,940.00	Facility		$165.00	$442.00	$5,940.00
United Facility/Professional Professional Modifier Low / Median / High Price $74.69 / $192.31 / $426.37	Professional		$74.69	$192.31	$426.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.18 / $93.78 / $164.78	Professional	26	$35.18	$93.78	$164.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.92 / $86.76 / $261.58	Professional	TC	$28.92	$86.76	$261.58