Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $144.54 / $186.21	Professional		$123.03	$144.54	$186.21
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $141.25 / $154.88	Professional		$125.89	$141.25	$154.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $199.53 / $263.03	Professional		$173.78	$199.53	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $131.83	Facility		$74.13	$74.13	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $79.43 / $141.25	Professional		$74.13	$79.43	$141.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10