Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.18 / $126.27 / $141.63	Facility	26	$52.18	$126.27	$141.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.67 / $425.02 / $596.54	Professional		$338.67	$425.02	$596.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.32 / $52.18 / $116.21	Professional	26	$51.32	$52.18	$116.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $287.33 / $369.97 / $516.44	Professional	TC	$287.33	$369.97	$516.44
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $405.66 / $450.73 / $599.47	Professional		$405.66	$450.73	$599.47
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $48.34 / $53.71 / $88.62	Professional	26	$48.34	$53.71	$88.62
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $357.32 / $397.02 / $432.75	Professional	TC	$357.32	$397.02	$432.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $256.70 / $1,181.13 / $1,982.58	Professional		$256.70	$1,181.13	$1,982.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.44 / $136.33 / $235.95	Professional	26	$59.44	$136.33	$235.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $166.54 / $1,064.06 / $1,746.63	Professional	TC	$166.54	$1,064.06	$1,746.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $491.05 / $1,090.89 / $1,090.89	Professional		$491.05	$1,090.89	$1,090.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.30 / $124.75 / $124.75	Professional	26	$56.30	$124.75	$124.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $434.75 / $966.14 / $966.14	Professional	TC	$434.75	$966.14	$966.14
United Facility/Professional Professional Modifier Low / Median / High Price $178.29 / $651.62 / $1,381.45	Professional		$178.29	$651.62	$1,381.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.49 / $75.81 / $157.97	Professional	26	$43.49	$75.81	$157.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.72 / $861.27 / $1,223.47	Professional	TC	$172.72	$861.27	$1,223.47