Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.63 / $167.07 / $417.96	Facility	26	$58.63	$167.07	$417.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.43 / $183.04 / $442.95	Professional		$169.43	$183.04	$442.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.52 / $62.95 / $141.88	Professional	26	$56.52	$62.95	$141.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.91 / $124.41 / $301.07	Professional	TC	$112.91	$124.41	$301.07
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $262.44 / $287.20 / $843.72	Professional		$262.44	$287.20	$843.72
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $71.95 / $78.43 / $118.72	Professional	26	$71.95	$78.43	$118.72
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $177.59 / $215.26 / $355.18	Professional	TC	$177.59	$215.26	$355.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $248.65 / $343.32 / $862.05	Professional		$248.65	$343.32	$862.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.98 / $95.75 / $271.80	Professional	26	$54.98	$95.75	$271.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $168.26 / $257.12 / $590.25	Professional	TC	$168.26	$257.12	$590.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.34 / $444.55 / $444.55	Professional		$199.34	$444.55	$444.55
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $65.29 / $143.75 / $143.75	Professional	26	$65.29	$143.75	$143.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $134.05 / $300.82 / $300.82	Professional	TC	$134.05	$300.82	$300.82
United Facility/Professional Professional Modifier Low / Median / High Price $174.85 / $600.19 / $674.77	Professional		$174.85	$600.19	$674.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.18 / $74.47 / $218.20	Professional	26	$47.18	$74.47	$218.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.71 / $197.80 / $456.57	Professional	TC	$112.71	$197.80	$456.57