Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $339.54 / $426.91 / $675.68	Facility	26	$339.54	$426.91	$675.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,195.30 / $1,338.23 / $3,234.10	Professional		$1,195.30	$1,338.23	$3,234.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $343.99 / $410.08 / $1,592.49	Professional	26	$343.99	$410.08	$1,592.49
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $1,423.58 / $1,494.13 / $1,897.55	Professional		$1,423.58	$1,494.13	$1,897.55
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $398.73 / $414.83 / $526.83	Professional	26	$398.73	$414.83	$526.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,195.80 / $1,868.13 / $3,330.75	Professional		$1,195.80	$1,868.13	$3,330.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $362.74 / $532.20 / $1,121.86	Professional	26	$362.74	$532.20	$1,121.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,237.03 / $1,595.77 / $2,893.71	Professional		$1,237.03	$1,595.77	$2,893.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $377.12 / $486.48 / $810.50	Professional	26	$377.12	$486.48	$810.50
United Facility/Professional Professional Modifier Low / Median / High Price $1,138.08 / $1,494.13 / $2,599.88	Professional		$1,138.08	$1,494.13	$2,599.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $327.50 / $441.95 / $723.95	Professional	26	$327.50	$441.95	$723.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,051.49 / $1,051.49 / $1,748.69	Professional		$1,051.49	$1,051.49	$1,748.69
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $320.60 / $320.60 / $533.64	Professional	26	$320.60	$320.60	$533.64