Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $112.20 / $302.00	Professional		$79.43	$112.20	$302.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $95.50 / $134.90	Professional		$87.10	$95.50	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $72.44	Facility		$50.12	$50.12	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $131.83 / $281.84	Professional		$89.13	$131.83	$281.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $234.42	Professional		$134.90	$154.88	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $213.80 / $467.74	Facility		$81.28	$213.80	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $120.23 / $218.78	Professional		$79.43	$120.23	$218.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $158.49 / $199.53	Professional		$109.65	$158.49	$199.53