Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $194.98 / $263.03	Professional		$162.18	$194.98	$263.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $199.53 / $229.09	Professional		$177.83	$199.53	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $173.78 / $316.23	Facility		$162.18	$173.78	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $281.84 / $354.81	Professional		$131.83	$281.84	$354.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $257.04 / $371.54	Professional		$234.42	$257.04	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $109.65 / $186.21	Facility		$104.71	$109.65	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $112.20 / $223.87	Professional		$104.71	$112.20	$223.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $123.03 / $371.54	Professional		$95.50	$123.03	$371.54