Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.28 / $54.98 / $80.17	Facility	26	$40.28	$54.98	$80.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.65 / $225.18 / $701.52	Professional		$123.65	$225.18	$701.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.81 / $52.59 / $168.86	Professional	26	$41.81	$52.59	$168.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.16 / $155.21 / $314.14	Professional	TC	$79.16	$155.21	$314.14
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $185.00 / $229.93 / $298.91	Professional		$185.00	$229.93	$298.91
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $55.10 / $55.48 / $70.13	Professional	26	$55.10	$55.48	$70.13
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $123.79 / $174.71 / $227.12	Professional	TC	$123.79	$174.71	$227.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.63 / $250.00 / $408.69	Professional		$115.63	$250.00	$408.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.54 / $60.88 / $110.18	Professional	26	$36.54	$60.88	$110.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.37 / $173.08 / $302.77	Professional	TC	$77.37	$173.08	$302.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $136.58 / $176.19 / $296.56	Professional		$136.58	$176.19	$296.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.61 / $56.69 / $97.59	Professional	26	$46.61	$56.69	$97.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $89.34 / $115.25 / $221.39	Professional	TC	$89.34	$115.25	$221.39
United Facility/Professional Professional Modifier Low / Median / High Price $126.46 / $194.67 / $423.35	Professional		$126.46	$194.67	$423.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.40 / $54.00 / $93.30	Professional	26	$27.40	$54.00	$93.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.25 / $128.76 / $256.41	Professional	TC	$87.25	$128.76	$256.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.26 / $148.28 / $192.76	Professional		$109.26	$148.28	$192.76
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $37.79 / $49.58 / $64.45	Professional	26	$37.79	$49.58	$64.45
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $71.47 / $98.70 / $126.18	Professional	TC	$71.47	$98.70	$126.18