Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.60 / $71.63 / $211.05	Facility	26	$29.60	$71.63	$211.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.35 / $107.61 / $128.46	Professional		$99.35	$107.61	$128.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.57 / $29.60 / $71.63	Professional	26	$28.57	$29.60	$71.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.77 / $78.00 / $91.83	Professional	TC	$70.77	$78.00	$91.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $130.52 / $130.58 / $442.79	Professional		$130.52	$130.58	$442.79
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $35.40 / $39.34 / $42.88	Professional	26	$35.40	$39.34	$42.88
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $82.12 / $91.24 / $99.45	Professional	TC	$82.12	$91.24	$99.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.87 / $155.08 / $466.68	Professional		$96.87	$155.08	$466.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.07 / $48.90 / $126.10	Professional	26	$28.07	$48.90	$126.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.48 / $102.61 / $340.58	Professional	TC	$67.48	$102.61	$340.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $115.74 / $134.01 / $258.88	Professional		$115.74	$134.01	$258.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.33 / $38.59 / $72.59	Professional	26	$33.33	$38.59	$72.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $82.41 / $95.43 / $186.30	Professional	TC	$82.41	$95.43	$186.30
United Facility/Professional Professional Modifier Low / Median / High Price $90.89 / $119.48 / $328.04	Professional		$90.89	$119.48	$328.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.28 / $40.00 / $91.98	Professional	26	$27.28	$40.00	$91.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.63 / $92.71 / $236.06	Professional	TC	$57.63	$92.71	$236.06