Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $91.20 / $229.09	Facility	26	$30.90	$91.20	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $138.04 / $331.13	Professional		$83.18	$138.04	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $37.15 / $100.00	Professional	26	$28.18	$37.15	$100.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $112.20 / $190.55	Professional	TC	$93.33	$112.20	$190.55
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $165.96 / $309.03	Professional		$112.20	$165.96	$309.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $38.02 / $41.69	Professional	26	$33.88	$38.02	$41.69
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $123.03 / $138.04	Professional	TC	$85.11	$123.03	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $380.19	Professional		$125.89	$162.18	$380.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $39.81 / $81.28	Professional	26	$28.18	$39.81	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $123.03 / $295.12	Professional	TC	$89.13	$123.03	$295.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $165.96 / $346.74	Professional		$151.36	$165.96	$346.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $38.02 / $77.62	Professional	26	$36.31	$38.02	$77.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $128.82 / $269.15	Professional	TC	$117.49	$128.82	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $154.88 / $446.68	Professional		$131.83	$154.88	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $38.02 / $102.33	Professional	26	$30.90	$38.02	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $117.49 / $346.74	Professional	TC	$102.33	$117.49	$346.74