Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $363.08	Professional		$134.90	$190.55	$363.08
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $309.03 / $346.74	Professional		$275.42	$309.03	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $446.68 / $575.44	Professional		$380.19	$446.68	$575.44
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $162.18 / $295.12	Facility		$81.28	$162.18	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $87.10 / $177.83	Professional		$81.28	$87.10	$177.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55