Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $489.78	Facility		$371.54	$371.54	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $758.58	Professional		$30.20	$50.12	$758.58
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $389.05 / $758.58 / $870.96	Professional	AA	$389.05	$758.58	$870.96
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $295.12 / $371.54 / $549.54	Professional	QX	$295.12	$371.54	$549.54
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $295.12 / $309.03 / $489.78	Professional	QY	$295.12	$309.03	$489.78
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $141.25 / $812.83 / $977.24	Professional	QZ	$141.25	$812.83	$977.24
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $2.95 / $3.47 / $5.13	Professional		$2.95	$3.47	$5.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $354.81 / $467.74	Professional		$239.88	$354.81	$467.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $371.54 / $478.63	Professional		$269.15	$371.54	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $60.26 / $87.10	Professional		$44.67	$60.26	$87.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $151.36	Professional		$102.33	$102.33	$151.36