Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $121.16 / $293.20 / $328.84	Facility	26	$121.16	$293.20	$328.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.07 / $212.72 / $499.77	Professional		$198.07	$212.72	$499.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $119.42 / $121.16 / $185.88	Professional	26	$119.42	$121.16	$185.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.65 / $92.39 / $144.84	Professional	TC	$78.65	$92.39	$144.84
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $188.00 / $208.89 / $344.67	Professional		$188.00	$208.89	$344.67
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $107.68 / $119.65 / $197.42	Professional	26	$107.68	$119.65	$197.42
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $80.31 / $89.24 / $147.25	Professional	TC	$80.31	$89.24	$147.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.49 / $542.01 / $897.77	Professional		$230.49	$542.01	$897.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $138.61 / $313.93 / $549.60	Professional	26	$138.61	$313.93	$549.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.88 / $226.18 / $348.17	Professional	TC	$91.88	$226.18	$348.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $217.75 / $487.52 / $487.52	Professional		$217.75	$487.52	$487.52
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $130.94 / $288.33 / $288.33	Professional	26	$130.94	$288.33	$288.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $86.80 / $199.20 / $199.20	Professional	TC	$86.80	$199.20	$199.20
United Facility/Professional Professional Modifier Low / Median / High Price $186.09 / $302.55 / $641.48	Professional		$186.09	$302.55	$641.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.43 / $174.80 / $365.14	Professional	26	$109.43	$174.80	$365.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.89 / $128.21 / $279.94	Professional	TC	$77.89	$128.21	$279.94