Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.88 / $193.68 / $525.52	Facility	26	$73.88	$193.68	$525.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.20 / $179.54 / $229.81	Professional		$167.20	$179.54	$229.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.30 / $73.88 / $178.78	Professional	26	$71.30	$73.88	$178.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.90 / $105.65 / $141.93	Professional	TC	$95.90	$105.65	$141.93
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $258.58 / $278.50 / $2,028.66	Professional		$258.58	$278.50	$2,028.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $90.48 / $90.48 / $106.70	Professional	26	$90.48	$90.48	$106.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $151.87 / $188.02 / $204.94	Professional	TC	$151.87	$188.02	$204.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.10 / $298.42 / $839.99	Professional		$232.10	$298.42	$839.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.44 / $120.54 / $341.37	Professional	26	$69.44	$120.54	$341.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $137.78 / $171.16 / $498.62	Professional	TC	$137.78	$171.16	$498.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $192.40 / $228.65 / $438.01	Professional		$192.40	$228.65	$438.01
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $82.46 / $95.48 / $180.75	Professional	26	$82.46	$95.48	$180.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $109.64 / $133.16 / $257.26	Professional	TC	$109.64	$133.16	$257.26
United Facility/Professional Professional Modifier Low / Median / High Price $160.47 / $218.91 / $664.83	Professional		$160.47	$218.91	$664.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.18 / $93.96 / $274.35	Professional	26	$65.18	$93.96	$274.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.06 / $159.58 / $390.48	Professional	TC	$88.06	$159.58	$390.48