Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $107.15 / $125.89	Professional		$102.33	$107.15	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $40.74 / $162.18	Professional	26	$30.90	$40.74	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $72.44 / $93.33	Professional	TC	$70.79	$72.44	$93.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $138.04 / $199.53	Professional		$112.20	$138.04	$199.53
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $38.90 / $75.86	Professional	26	$35.48	$38.90	$75.86
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $102.33 / $147.91	Professional	TC	$100.00	$102.33	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $134.90 / $588.84	Professional		$63.10	$134.90	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $35.48 / $154.88	Professional	26	$18.62	$35.48	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $102.33 / $426.58	Professional	TC	$40.74	$102.33	$426.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $346.74 / $346.74	Professional		$194.98	$346.74	$346.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $91.20 / $91.20	Professional	26	$50.12	$91.20	$91.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $257.04 / $257.04	Professional	TC	$144.54	$257.04	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $501.19	Professional		$87.10	$102.33	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $30.90 / $131.83	Professional	26	$28.18	$30.90	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $72.44 / $371.54	Professional	TC	$58.88	$72.44	$371.54