Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	26	$125.89	$125.89	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $208.93 / $380.19	Professional	26	$112.20	$208.93	$380.19
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $123.03 / $131.83	Professional	26	$109.65	$123.03	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $125.89 / $223.87	Professional	26	$87.10	$125.89	$223.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $131.83 / $245.47	Professional	26	$109.65	$131.83	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $123.03 / $275.42	Professional	26	$83.18	$123.03	$275.42
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $131.83 / $169.82	Professional	26	$93.33	$131.83	$169.82