Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.47 / $143.91 / $424.46	Facility	26	$59.47	$143.91	$424.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $397.67 / $434.35 / $1,051.11	Professional		$397.67	$434.35	$1,051.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.47 / $59.47 / $143.91	Professional	26	$57.47	$59.47	$143.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $340.21 / $374.89 / $907.23	Professional	TC	$340.21	$374.89	$907.23
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $562.12 / $665.97 / $1,319.05	Professional		$562.12	$665.97	$1,319.05
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $79.00 / $80.77 / $88.04	Professional	26	$79.00	$80.77	$88.04
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $483.12 / $530.21 / $577.92	Professional	TC	$483.12	$530.21	$577.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $824.81 / $1,165.30 / $2,465.38	Professional		$824.81	$1,165.30	$2,465.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.15 / $109.03 / $325.72	Professional	26	$56.15	$109.03	$325.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $715.78 / $1,009.86 / $2,139.67	Professional	TC	$715.78	$1,009.86	$2,139.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $460.77 / $1,038.75 / $1,038.75	Professional		$460.77	$1,038.75	$1,038.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $66.67 / $145.99 / $145.99	Professional	26	$66.67	$145.99	$145.99
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $394.09 / $892.76 / $892.76	Professional	TC	$394.09	$892.76	$892.76
United Facility/Professional Professional Modifier Low / Median / High Price $425.71 / $553.14 / $1,553.86	Professional		$425.71	$553.14	$1,553.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.01 / $96.92 / $218.38	Professional	26	$56.01	$96.92	$218.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $369.70 / $988.26 / $1,335.48	Professional	TC	$369.70	$988.26	$1,335.48