Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.22 / $131.84 / $148.01	Professional		$116.22	$131.84	$148.01
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $134.60 / $134.60 / $164.29	Professional		$134.60	$134.60	$164.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $445.00 / $453.73 / $791.44	Facility		$445.00	$453.73	$791.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.10 / $166.86 / $326.99	Professional		$125.10	$166.86	$326.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $159.44 / $208.92 / $295.66	Professional		$159.44	$208.92	$295.66
United Facility/Professional Facility Modifier Low / Median / High Price $215.00 / $215.00 / $471.00	Facility		$215.00	$215.00	$471.00
United Facility/Professional Professional Modifier Low / Median / High Price $95.37 / $146.07 / $279.94	Professional		$95.37	$146.07	$279.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $118.95 / $186.24 / $223.80	Professional		$118.95	$186.24	$223.80