Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.17 / $211.37 / $527.65	Facility	26	$74.17	$211.37	$527.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.50 / $249.27 / $431.44	Professional		$230.50	$249.27	$431.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.58 / $80.31 / $172.80	Professional	26	$71.58	$80.31	$172.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.91 / $175.10 / $351.12	Professional	TC	$158.91	$175.10	$351.12
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $368.67 / $413.76 / $1,467.96	Professional		$368.67	$413.76	$1,467.96
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $83.70 / $91.20 / $107.14	Professional	26	$83.70	$91.20	$107.14
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $278.51 / $322.56 / $351.59	Professional	TC	$278.51	$322.56	$351.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $375.91 / $585.96 / $1,293.48	Professional		$375.91	$585.96	$1,293.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.72 / $121.03 / $342.70	Professional	26	$69.72	$121.03	$342.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $274.02 / $501.91 / $1,046.15	Professional	TC	$274.02	$501.91	$1,046.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $301.07 / $668.58 / $668.58	Professional		$301.07	$668.58	$668.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $82.79 / $181.48 / $181.48	Professional	26	$82.79	$181.48	$181.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $218.29 / $487.12 / $487.12	Professional	TC	$218.29	$487.12	$487.12
United Facility/Professional Professional Modifier Low / Median / High Price $269.89 / $528.27 / $1,100.54	Professional		$269.89	$528.27	$1,100.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.62 / $145.78 / $275.45	Professional	26	$67.62	$145.78	$275.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $206.97 / $468.66 / $893.99	Professional	TC	$206.97	$468.66	$893.99