Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $302.00 / $851.14	Facility		$114.82	$302.00	$851.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $72.44 / $177.83	Facility	26	$25.12	$72.44	$177.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $58.88 / $169.82 / $416.87	Facility	TC	$58.88	$169.82	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $102.33 / $213.80	Professional		$70.79	$102.33	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $35.48 / $107.15	Professional	26	$22.91	$35.48	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $70.79 / $213.80	Professional	TC	$50.12	$70.79	$213.80
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $97.72 / $323.59	Professional		$26.30	$97.72	$323.59
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $29.51 / $63.10	Professional	26	$26.92	$29.51	$63.10
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $67.61 / $123.03	Professional	TC	$61.66	$67.61	$123.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $489.78 / $602.56	Facility		$275.42	$489.78	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $251.19	Professional		$75.86	$109.65	$251.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $33.11 / $63.10	Professional	26	$21.88	$33.11	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $74.13 / $173.78	Professional	TC	$53.70	$74.13	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $100.00 / $204.17	Professional		$91.20	$100.00	$204.17
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $29.51 / $60.26	Professional	26	$28.18	$29.51	$60.26
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $69.18 / $144.54	Professional	TC	$63.10	$69.18	$144.54
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 $83.18 / $100.00 / $263.03	Professional		$83.18	$100.00	$263.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $29.51 / $77.62	Professional	26	$23.99	$29.51	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $72.44 / $199.53	Professional	TC	$56.23	$72.44	$199.53