Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.45 / $5.45 / $5.45	Facility	26	$5.45	$5.45	$5.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.45 / $5.82 / $7.84	Professional	26	$5.45	$5.82	$7.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.84 / $19.44 / $27.95	Professional	TC	$18.84	$19.44	$27.95
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $18.62 / $23.28	Professional	26	$18.62	$18.62	$23.28
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $64.44 / $64.44 / $80.55	Professional	TC	$64.44	$64.44	$80.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.86 / $44.63 / $103.59	Professional	26	$25.86	$44.63	$103.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.34 / $157.50 / $345.57	Professional	TC	$83.34	$157.50	$345.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.71 / $25.86 / $54.09	Professional	26	$22.71	$25.86	$54.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $71.47 / $88.28 / $187.09	Professional	TC	$71.47	$88.28	$187.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.10 / $65.06 / $68.50	Professional	26	$18.10	$65.06	$68.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $175.32 / $225.08 / $236.92	Professional	TC	$175.32	$225.08	$236.92