Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.91 / $170.77 / $561.02	Facility	26	$62.91	$170.77	$561.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.91 / $195.84 / $304.64	Professional		$184.91	$195.84	$304.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.91 / $69.87 / $152.24	Professional	26	$62.91	$69.87	$152.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $122.00 / $127.15 / $199.37	Professional	TC	$122.00	$127.15	$199.37
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $202.39 / $202.39 / $410.65	Professional		$202.39	$202.39	$410.65
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $66.18 / $66.18 / $195.82	Professional	26	$66.18	$66.18	$195.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $136.21 / $136.21 / $148.86	Professional	TC	$136.21	$136.21	$148.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.55 / $246.64 / $705.11	Professional		$175.55	$246.64	$705.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.44 / $100.16 / $239.91	Professional	26	$68.44	$100.16	$239.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.40 / $162.72 / $465.21	Professional	TC	$112.40	$162.72	$465.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $188.45 / $224.93 / $435.00	Professional		$188.45	$224.93	$435.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $68.00 / $78.63 / $149.51	Professional	26	$68.00	$78.63	$149.51
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $120.45 / $146.31 / $285.49	Professional	TC	$120.45	$146.31	$285.49
United Facility/Professional Professional Modifier Low / Median / High Price $166.41 / $267.41 / $538.62	Professional		$166.41	$267.41	$538.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.74 / $88.32 / $163.31	Professional	26	$58.74	$88.32	$163.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.67 / $179.96 / $348.90	Professional	TC	$107.67	$179.96	$348.90