Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $89.13 / $123.03	Professional		$72.44	$89.13	$123.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $89.13 / $102.33	Professional		$81.28	$89.13	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Facility		$58.88	$58.88	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $128.82 / $162.18	Professional		$58.88	$128.82	$162.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $117.49 / $169.82	Professional		$107.15	$117.49	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $53.70 / $112.20	Facility		$46.77	$53.70	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $52.48 / $109.65	Professional		$46.77	$52.48	$109.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $6.76 / $8.71 / $169.82	Professional		$6.76	$8.71	$169.82