Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.66 / $67.44 / $168.14	Facility	26	$23.66	$67.44	$168.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.93 / $96.41 / $103.01	Professional		$88.93	$96.41	$103.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.87 / $23.66 / $57.25	Professional	26	$22.87	$23.66	$57.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.06 / $72.73 / $78.51	Professional	TC	$66.06	$72.73	$78.51
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $98.60 / $110.67 / $271.92	Professional		$98.60	$110.67	$271.92
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $25.36 / $28.18 / $30.72	Professional	26	$25.36	$28.18	$30.72
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $73.50 / $82.49 / $89.91	Professional	TC	$73.50	$82.49	$89.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.66 / $127.57 / $411.64	Professional		$89.66	$127.57	$411.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.12 / $37.42 / $100.86	Professional	26	$22.12	$37.42	$100.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.76 / $88.45 / $310.77	Professional	TC	$65.76	$88.45	$310.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $106.47 / $123.28 / $236.06	Professional		$106.47	$123.28	$236.06
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.27 / $30.42 / $57.83	Professional	26	$26.27	$30.42	$57.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $80.20 / $92.86 / $178.21	Professional	TC	$80.20	$92.86	$178.21
United Facility/Professional Professional Modifier Low / Median / High Price $81.76 / $122.40 / $299.11	Professional		$81.76	$122.40	$299.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.94 / $37.75 / $73.28	Professional	26	$20.94	$37.75	$73.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.82 / $199.15 / $225.83	Professional	TC	$60.82	$199.15	$225.83