Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.81 / $119.15 / $301.52	Facility	26	$41.81	$119.15	$301.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.92 / $127.38 / $255.01	Professional		$117.92	$127.38	$255.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $46.51 / $101.18	Professional	26	$40.29	$46.51	$101.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.64 / $85.57 / $201.03	Professional	TC	$77.64	$85.57	$201.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $183.58 / $225.47 / $842.51	Professional		$183.58	$225.47	$842.51
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $51.90 / $56.57 / $85.63	Professional	26	$51.90	$56.57	$85.63
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $122.36 / $173.57 / $286.39	Professional	TC	$122.36	$173.57	$286.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.74 / $332.85 / $600.36	Professional		$182.74	$332.85	$600.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.67 / $69.51 / $196.48	Professional	26	$39.67	$69.51	$196.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $118.96 / $253.39 / $406.34	Professional	TC	$118.96	$253.39	$406.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $140.13 / $310.95 / $310.95	Professional		$140.13	$310.95	$310.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.10 / $103.71 / $103.71	Professional	26	$47.10	$103.71	$103.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $93.03 / $207.27 / $207.27	Professional	TC	$93.03	$207.27	$207.27
United Facility/Professional Professional Modifier Low / Median / High Price $123.61 / $223.25 / $472.00	Professional		$123.61	$223.25	$472.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.59 / $54.00 / $157.41	Professional	26	$22.59	$54.00	$157.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.37 / $157.80 / $352.35	Professional	TC	$95.37	$157.80	$352.35