Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $331.13 / $426.58	Professional		$281.84	$331.13	$426.58
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $323.59 / $363.08	Professional		$295.12	$323.59	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Professional		$213.80	$213.80	$213.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $467.74 / $616.60	Professional		$407.38	$467.74	$616.60
United Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $309.03	Facility		$169.82	$169.82	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $181.97 / $331.13	Professional		$169.82	$181.97	$331.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $323.59 / $323.59	Professional		$204.17	$323.59	$323.59