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 $100.00 / $155.19 / $335.00	Professional	26	$100.00	$155.19	$335.00
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $121.08 / $127.39 / $139.32	Professional	26	$121.08	$127.39	$139.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.08 / $130.74 / $295.77	Professional	26	$87.08	$130.74	$295.77
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $110.27 / $146.84 / $246.12	Professional	26	$110.27	$146.84	$246.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.72 / $121.62 / $274.67	Professional	26	$83.72	$121.62	$274.67
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $78.66 / $91.06 / $154.94	Professional	26	$78.66	$91.06	$154.94