Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.24 / $42.24 / $42.24	Facility	26	$42.24	$42.24	$42.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.30 / $113.48 / $294.00	Professional		$96.30	$113.48	$294.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.51 / $43.59 / $95.52	Professional	26	$30.51	$43.59	$95.52
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $124.40 / $139.11 / $176.67	Professional		$124.40	$139.11	$176.67
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $36.32 / $45.15 / $57.34	Professional	26	$36.32	$45.15	$57.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.54 / $125.07 / $252.60	Professional		$83.54	$125.07	$252.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.22 / $45.87 / $106.73	Professional	26	$32.22	$45.87	$106.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.51 / $135.19 / $203.53	Professional		$109.51	$135.19	$203.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.52 / $56.09 / $73.16	Professional	26	$40.52	$56.09	$73.16
United Facility/Professional Professional Modifier Low / Median / High Price $83.50 / $112.97 / $195.56	Professional		$83.50	$112.97	$195.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.26 / $35.36 / $71.56	Professional	26	$27.26	$35.36	$71.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.61 / $117.96 / $156.38	Professional		$87.61	$117.96	$156.38
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $39.02 / $51.80 / $70.64	Professional	26	$39.02	$51.80	$70.64