Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.45 / $259.38 / $716.81	Facility	26	$79.45	$259.38	$716.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.61 / $254.55 / $438.26	Professional		$235.61	$254.55	$438.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.69 / $79.45 / $192.26	Professional	26	$76.69	$79.45	$192.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.91 / $175.10 / $350.77	Professional	TC	$158.91	$175.10	$350.77
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $421.00 / $462.91 / $1,512.70	Professional		$421.00	$462.91	$1,512.70
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $88.20 / $98.98 / $115.36	Professional	26	$88.20	$98.98	$115.36
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $312.79 / $344.00 / $365.34	Professional	TC	$312.79	$344.00	$365.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $408.53 / $596.12 / $1,529.23	Professional		$408.53	$596.12	$1,529.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.34 / $130.79 / $367.22	Professional	26	$75.34	$130.79	$367.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $307.33 / $492.24 / $1,162.01	Professional	TC	$307.33	$492.24	$1,162.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $340.25 / $407.67 / $784.13	Professional		$340.25	$407.67	$784.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $89.48 / $103.61 / $195.40	Professional	26	$89.48	$103.61	$195.40
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $250.31 / $304.06 / $588.71	Professional	TC	$250.31	$304.06	$588.71
United Facility/Professional Professional Modifier Low / Median / High Price $282.60 / $429.10 / $1,190.20	Professional		$282.60	$429.10	$1,190.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.31 / $101.07 / $296.58	Professional	26	$64.31	$101.07	$296.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.45 / $306.49 / $893.61	Professional	TC	$204.45	$306.49	$893.61