Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.04 / $131.21 / $329.54	Facility	26	$46.04	$131.21	$329.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.77 / $131.29 / $253.75	Professional		$121.77	$131.29	$253.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.43 / $46.04 / $108.05	Professional	26	$44.43	$46.04	$108.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.34 / $85.24 / $198.60	Professional	TC	$77.34	$85.24	$198.60
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $188.80 / $204.09 / $833.51	Professional		$188.80	$204.09	$833.51
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $56.34 / $61.41 / $92.96	Professional	26	$56.34	$61.41	$92.96
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $121.88 / $147.75 / $243.79	Professional	TC	$121.88	$147.75	$243.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.80 / $329.24 / $615.39	Professional		$164.80	$329.24	$615.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.35 / $75.33 / $213.06	Professional	26	$43.35	$75.33	$213.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.92 / $253.39 / $402.33	Professional	TC	$106.92	$253.39	$402.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $143.78 / $319.80 / $319.80	Professional		$143.78	$319.80	$319.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.48 / $113.34 / $113.34	Professional	26	$51.48	$113.34	$113.34
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $92.30 / $206.46 / $206.46	Professional	TC	$92.30	$206.46	$206.46
United Facility/Professional Professional Modifier Low / Median / High Price $119.31 / $208.30 / $485.42	Professional		$119.31	$208.30	$485.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.49 / $58.52 / $172.04	Professional	26	$37.49	$58.52	$172.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.90 / $134.86 / $313.38	Professional	TC	$89.90	$134.86	$313.38