Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.83 / $244.40 / $473.93	Facility	26	$53.83	$244.40	$473.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.47 / $172.32 / $314.94	Professional		$159.47	$172.32	$314.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.94 / $53.83 / $63.10	Professional	26	$51.94	$53.83	$63.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.53 / $118.49 / $256.70	Professional	TC	$107.53	$118.49	$256.70
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $232.64 / $247.33 / $992.58	Professional		$232.64	$247.33	$992.58
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $66.39 / $72.37 / $109.54	Professional	26	$66.39	$72.37	$109.54
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $152.11 / $169.01 / $274.33	Professional	TC	$152.11	$169.01	$274.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.18 / $391.81 / $811.76	Professional		$222.18	$391.81	$811.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.74 / $87.96 / $251.02	Professional	26	$50.74	$87.96	$251.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $153.88 / $318.45 / $560.74	Professional	TC	$153.88	$318.45	$560.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $188.07 / $418.96 / $418.96	Professional		$188.07	$418.96	$418.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.25 / $132.65 / $132.65	Professional	26	$60.25	$132.65	$132.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $127.82 / $286.29 / $286.29	Professional	TC	$127.82	$286.29	$286.29
United Facility/Professional Professional Modifier Low / Median / High Price $152.63 / $275.20 / $635.91	Professional		$152.63	$275.20	$635.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.45 / $75.59 / $201.35	Professional	26	$43.45	$75.59	$201.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $116.28 / $189.32 / $434.57	Professional	TC	$116.28	$189.32	$434.57