Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.89 / $289.16 / $293.06	Professional		$257.89	$289.16	$293.06
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $281.33 / $312.60 / $425.14	Professional		$281.33	$312.60	$425.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $207.10 / $207.10 / $207.10	Facility		$207.10	$207.10	$207.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.10 / $448.93 / $561.16	Professional		$207.10	$448.93	$561.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $390.75 / $449.36 / $586.13	Professional		$390.75	$449.36	$586.13
United Facility/Professional Professional Modifier Low / Median / High Price $164.12 / $183.65 / $355.57	Professional		$164.12	$183.65	$355.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $198.46 / $203.55 / $254.44	Professional		$198.46	$203.55	$254.44