Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.99 / $49.09 / $71.62	Facility	26	$35.99	$49.09	$71.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $362.83 / $411.83 / $689.37	Professional		$362.83	$411.83	$689.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.99 / $37.29 / $93.57	Professional	26	$35.99	$37.29	$93.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $326.83 / $375.12 / $653.66	Professional	TC	$326.83	$375.12	$653.66
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $367.98 / $403.38 / $463.89	Professional		$367.98	$403.38	$463.89
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $45.91 / $45.91 / $52.80	Professional	26	$45.91	$45.91	$52.80
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $322.08 / $357.47 / $411.09	Professional	TC	$322.08	$357.47	$411.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $314.30 / $524.51 / $1,093.66	Professional		$314.30	$524.51	$1,093.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.29 / $47.88 / $110.16	Professional	26	$32.29	$47.88	$110.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $281.66 / $476.63 / $983.50	Professional	TC	$281.66	$476.63	$983.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $383.60 / $482.05 / $892.68	Professional		$383.60	$482.05	$892.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $48.66 / $87.40	Professional	26	$40.09	$48.66	$87.40
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $342.69 / $434.27 / $804.20	Professional	TC	$342.69	$434.27	$804.20
United Facility/Professional Professional Modifier Low / Median / High Price $357.07 / $457.26 / $809.73	Professional		$357.07	$457.26	$809.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.40 / $40.67 / $103.43	Professional	26	$32.40	$40.67	$103.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $315.33 / $415.19 / $830.07	Professional	TC	$315.33	$415.19	$830.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $325.06 / $372.89 / $575.40	Professional		$325.06	$372.89	$575.40
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.76 / $38.74 / $57.51	Professional	26	$33.76	$38.74	$57.51
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $291.31 / $334.18 / $514.04	Professional	TC	$291.31	$334.18	$514.04