Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $234.42 / $588.84	Professional		$147.91	$234.42	$588.84
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $169.82 / $218.78	Professional		$154.88	$169.82	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $338.84 / $676.08	Facility		$331.13	$338.84	$676.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $275.42 / $575.44	Professional		$158.49	$275.42	$575.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $398.11 / $588.84	Professional		$346.74	$398.11	$588.84
United Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $141.25 / $281.84	Facility		$112.20	$141.25	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $251.19 / $489.78	Professional		$141.25	$251.19	$489.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $416.87 / $501.19	Professional		$141.25	$416.87	$501.19