Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $19.05 / $19.05	Facility	26	$19.05	$19.05	$19.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.90 / $53.08 / $200.78	Professional		$40.90	$53.08	$200.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $22.00 / $73.53	Professional	26	$19.05	$22.00	$73.53
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $60.61 / $67.34 / $112.27	Professional		$60.61	$67.34	$112.27
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $27.32 / $30.36 / $34.35	Professional	26	$27.32	$30.36	$34.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.29 / $70.47 / $131.43	Professional		$37.29	$70.47	$131.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.23 / $28.94 / $58.80	Professional	26	$17.23	$28.94	$58.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.22 / $62.20 / $107.13	Professional		$48.22	$62.20	$107.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.69 / $28.90 / $48.27	Professional	26	$22.69	$28.90	$48.27
United Facility/Professional Professional Modifier Low / Median / High Price $42.32 / $63.48 / $97.75	Professional		$42.32	$63.48	$97.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.82 / $26.20 / $41.94	Professional	26	$19.82	$26.20	$41.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.22 / $55.45 / $68.90	Professional		$48.22	$55.45	$68.90
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.69 / $26.09 / $32.93	Professional	26	$22.69	$26.09	$32.93