Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.79 / $328.95 / $668.99	Facility	26	$75.79	$328.95	$668.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.66 / $246.59 / $560.61	Professional		$231.66	$246.59	$560.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.79 / $82.98 / $126.07	Professional	26	$75.79	$82.98	$126.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $155.87 / $155.87 / $257.39	Professional	TC	$155.87	$155.87	$257.39
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $248.79 / $268.22 / $709.81	Professional		$248.79	$268.22	$709.81
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $88.11 / $95.02 / $182.57	Professional	26	$88.11	$95.02	$182.57
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $155.41 / $166.30 / $295.45	Professional	TC	$155.41	$166.30	$295.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.62 / $351.89 / $883.38	Professional		$240.62	$351.89	$883.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.79 / $120.91 / $289.00	Professional	26	$81.79	$120.91	$289.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.21 / $217.93 / $594.39	Professional	TC	$154.21	$217.93	$594.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $237.29 / $283.32 / $545.21	Professional		$237.29	$283.32	$545.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.47 / $94.19 / $179.10	Professional	26	$81.47	$94.19	$179.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $155.82 / $189.12 / $366.11	Professional	TC	$155.82	$189.12	$366.11
United Facility/Professional Professional Modifier Low / Median / High Price $203.38 / $310.55 / $667.08	Professional		$203.38	$310.55	$667.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.80 / $105.81 / $194.75	Professional	26	$70.80	$105.81	$194.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $129.90 / $204.22 / $439.80	Professional	TC	$129.90	$204.22	$439.80