Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $154.88 / $389.05	Facility	26	$52.48	$154.88	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $288.40 / $549.54	Professional		$218.78	$288.40	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $83.18 / $208.93	Professional	26	$54.95	$83.18	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $213.80 / $524.81	Professional	TC	$162.18	$213.80	$524.81
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $331.13 / $1,288.25	Professional		$239.88	$331.13	$1,288.25
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $70.79 / $77.62	Professional	26	$66.07	$70.79	$77.62
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $234.42 / $426.58	Professional	TC	$218.78	$234.42	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $354.81 / $707.95	Professional		$199.53	$354.81	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $169.82	Professional	26	$51.29	$72.44	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $281.84 / $549.54	Professional	TC	$144.54	$281.84	$549.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $269.15 / $562.34	Professional		$245.47	$269.15	$562.34
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $63.10 / $131.83	Professional	26	$60.26	$63.10	$131.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $204.17 / $436.52	Professional	TC	$186.21	$204.17	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $338.84 / $870.96	Professional		$213.80	$338.84	$870.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $75.86 / $199.53	Professional	26	$43.65	$75.86	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $263.03 / $660.69	Professional	TC	$158.49	$263.03	$660.69