Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.00 / $125.00 / $125.00	Facility	26	$125.00	$125.00	$125.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.00 / $125.00 / $265.00	Professional	26	$90.00	$125.00	$265.00
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $73.76 / $85.09 / $92.75	Professional	26	$73.76	$85.09	$92.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.81 / $77.80 / $180.10	Professional	26	$52.81	$77.80	$180.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $66.78 / $82.88 / $148.22	Professional	26	$66.78	$82.88	$148.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.87 / $78.29 / $223.40	Professional	26	$52.87	$78.29	$223.40
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $46.95 / $54.95 / $93.69	Professional	26	$46.95	$54.95	$93.69