Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.12 / $75.31 / $221.98	Facility	26	$31.12	$75.31	$221.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.84 / $104.68 / $240.18	Professional		$91.84	$104.68	$240.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.12 / $32.67 / $88.69	Professional	26	$31.12	$32.67	$88.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $56.34 / $364.35 / $728.70	Professional	50	$56.34	$364.35	$728.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.92 / $68.13 / $116.77	Professional	TC	$62.92	$68.13	$116.77
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $111.18 / $115.67 / $219.98	Professional		$111.18	$115.67	$219.98
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.03 / $40.03 / $68.63	Professional	26	$40.03	$40.03	$68.63
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $71.15 / $75.64 / $87.48	Professional	TC	$71.15	$75.64	$87.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.17 / $130.74 / $326.48	Professional		$89.17	$130.74	$326.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.50 / $43.15 / $107.21	Professional	26	$29.50	$43.15	$107.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.44 / $87.41 / $219.27	Professional	TC	$58.44	$87.41	$219.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.76 / $241.67 / $241.67	Professional		$114.76	$241.67	$241.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.88 / $76.34 / $76.34	Professional	26	$36.88	$76.34	$76.34
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $77.88 / $165.32 / $165.32	Professional	TC	$77.88	$165.32	$165.32
United Facility/Professional Professional Modifier Low / Median / High Price $92.64 / $154.36 / $350.17	Professional		$92.64	$154.36	$350.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.90 / $45.15 / $105.09	Professional	26	$28.90	$45.15	$105.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.40 / $84.15 / $239.54	Professional	TC	$61.40	$84.15	$239.54