Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.80 / $124.80 / $157.44	Professional		$124.80	$124.80	$157.44
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $176.64 / $176.64 / $307.20	Professional		$176.64	$176.64	$307.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $203.52 / $203.52 / $203.52	Professional		$203.52	$203.52	$203.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $384.00 / $441.60 / $576.00	Professional		$384.00	$441.60	$576.00
United Facility/Professional Facility Modifier Low / Median / High Price $161.28 / $161.28 / $161.28	Facility		$161.28	$161.28	$161.28
United Facility/Professional Professional Modifier Low / Median / High Price $80.64 / $86.40 / $192.00	Professional		$80.64	$86.40	$192.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $192.00 / $192.00 / $192.00	Professional		$192.00	$192.00	$192.00