Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $117.49 / $616.60	Facility		$43.65	$117.49	$616.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $158.49 / $194.98	Facility	26	$26.92	$158.49	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $104.71 / $239.88	Professional		$40.74	$104.71	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $47.86 / $141.25	Professional	26	$25.70	$47.86	$141.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $112.20 / $186.21 / $363.08	Professional	50	$112.20	$186.21	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $25.70 / $66.07	Professional	TC	$14.13	$25.70	$66.07
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $48.98 / $398.11	Professional		$20.42	$48.98	$398.11
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $35.48 / $44.67	Professional	26	$28.84	$35.48	$44.67
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $18.20 / $75.86	Professional	TC	$18.20	$18.20	$75.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $147.91 / $380.19	Facility		$83.18	$147.91	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $97.72 / $190.55	Professional		$41.69	$97.72	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $46.77 / $89.13	Professional	26	$25.12	$46.77	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $43.65 / $95.50	Professional	TC	$16.22	$43.65	$95.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $54.95 / $125.89	Professional		$51.29	$54.95	$125.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $33.88 / $69.18	Professional	26	$31.62	$33.88	$69.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $21.38 / $56.23	Professional	TC	$19.95	$21.38	$56.23
United Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $501.19 / $588.84	Facility		$426.58	$501.19	$588.84
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $72.44 / $162.18	Professional		$47.86	$72.44	$162.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $39.81 / $93.33	Professional	26	$28.84	$39.81	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $31.62 / $63.10	Professional	TC	$19.95	$31.62	$63.10