Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.88 / $82.88 / $82.88	Facility	26	$82.88	$82.88	$82.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $729.78 / $824.98 / $1,294.67	Professional		$729.78	$824.98	$1,294.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.88 / $85.75 / $154.34	Professional	26	$82.88	$85.75	$154.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $642.65 / $739.23 / $1,135.57	Professional	TC	$642.65	$739.23	$1,135.57
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $1,065.67 / $1,154.05 / $1,257.91	Professional		$1,065.67	$1,154.05	$1,257.91
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $113.40 / $114.81 / $125.14	Professional	26	$113.40	$114.81	$125.14
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $952.27 / $1,039.24 / $1,132.77	Professional	TC	$952.27	$1,039.24	$1,132.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $906.91 / $1,475.91 / $3,172.24	Professional		$906.91	$1,475.91	$3,172.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.88 / $108.70 / $251.98	Professional	26	$73.88	$108.70	$251.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $815.96 / $1,320.62 / $2,834.99	Professional	TC	$815.96	$1,320.62	$2,834.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $789.17 / $990.48 / $1,834.22	Professional		$789.17	$990.48	$1,834.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $91.53 / $111.05 / $201.90	Professional	26	$91.53	$111.05	$201.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $695.56 / $881.45 / $1,632.32	Professional	TC	$695.56	$881.45	$1,632.32
United Facility/Professional Professional Modifier Low / Median / High Price $718.52 / $1,013.07 / $2,945.81	Professional		$718.52	$1,013.07	$2,945.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.80 / $96.24 / $171.05	Professional	26	$75.80	$96.24	$171.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $642.79 / $881.58 / $2,115.86	Professional	TC	$642.79	$881.58	$2,115.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $668.34 / $828.80 / $1,183.75	Professional		$668.34	$828.80	$1,183.75
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $77.08 / $95.56 / $131.24	Professional	26	$77.08	$95.56	$131.24
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $591.26 / $733.24 / $1,043.33	Professional	TC	$591.26	$733.24	$1,043.33