Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $12.59 / $12.59	Facility	26	$12.59	$12.59	$12.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $95.50 / $213.80	Professional		$67.61	$95.50	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $64.57	Professional	26	$12.02	$15.14	$64.57
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $104.71 / $117.49	Professional		$14.45	$104.71	$117.49
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $15.49 / $18.20	Professional	26	$13.49	$15.49	$18.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $24.55 / $24.55	Facility	26	$24.55	$24.55	$24.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $93.33 / $199.53	Professional		$66.07	$93.33	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $17.38 / $33.88	Professional	26	$11.75	$17.38	$33.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $117.49 / $165.96	Professional		$100.00	$117.49	$165.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $17.78 / $23.99	Professional	26	$15.85	$17.78	$23.99
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $89.13 / $158.49	Professional		$60.26	$89.13	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $15.14 / $26.92	Professional	26	$11.48	$15.14	$26.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $123.03 / $165.96	Professional		$61.66	$123.03	$165.96
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $18.62 / $23.44	Professional	26	$8.71	$18.62	$23.44