Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $194.98	Professional		$128.82	$151.36	$194.98
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $147.91 / $165.96	Professional		$131.83	$147.91	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Professional		$97.72	$97.72	$97.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $213.80 / $275.42	Professional		$186.21	$213.80	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $141.25	Facility		$77.62	$77.62	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $83.18 / $151.36	Professional		$77.62	$83.18	$151.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33