Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.08 / $229.22 / $447.64	Facility	26	$55.08	$229.22	$447.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.96 / $216.02 / $216.02	Professional		$198.96	$216.02	$216.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.00 / $55.08 / $55.08	Professional	26	$53.00	$55.08	$55.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $145.96 / $160.94 / $160.94	Professional	TC	$145.96	$160.94	$160.94
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $246.93 / $309.55 / $2,596.16	Professional		$246.93	$309.55	$2,596.16
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $51.28 / $80.05 / $87.17	Professional	26	$51.28	$80.05	$87.17
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $181.39 / $229.49 / $364.26	Professional	TC	$181.39	$229.49	$364.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.45 / $572.49 / $1,099.22	Professional		$197.45	$572.49	$1,099.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.18 / $85.75 / $272.98	Professional	26	$52.18	$85.75	$272.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.28 / $514.90 / $826.24	Professional	TC	$145.28	$514.90	$826.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $234.48 / $524.36 / $524.36	Professional		$234.48	$524.36	$524.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.96 / $135.60 / $135.60	Professional	26	$61.96	$135.60	$135.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $172.52 / $388.73 / $388.73	Professional	TC	$172.52	$388.73	$388.73
United Facility/Professional Professional Modifier Low / Median / High Price $212.17 / $386.21 / $795.90	Professional		$212.17	$386.21	$795.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.88 / $141.21 / $205.83	Professional	26	$46.88	$141.21	$205.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.76 / $389.78 / $590.07	Professional	TC	$159.76	$389.78	$590.07