Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $138.04 / $181.97	Professional		$114.82	$138.04	$181.97
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $138.04 / $158.49	Professional		$125.89	$138.04	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $199.53 / $251.19	Professional		$91.20	$199.53	$251.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $181.97 / $257.04	Professional		$165.96	$181.97	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $81.28 / $173.78	Facility		$72.44	$81.28	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $81.28 / $165.96	Professional		$72.44	$81.28	$165.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $295.12 / $758.58	Professional		$257.04	$295.12	$758.58