Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $874.33 / $3,999.00 / $6,456.00	Facility		$874.33	$3,999.00	$6,456.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $301.31 / $375.25 / $375.25	Professional		$301.31	$375.25	$375.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $361.46 / $407.19 / $2,368.00	Professional		$361.46	$407.19	$2,368.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $359.80 / $578.28 / $998.38	Professional		$359.80	$578.28	$998.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $399.77 / $829.77 / $829.77	Professional		$399.77	$829.77	$829.77
United Facility/Professional Facility Modifier Low / Median / High Price $665.00 / $1,463.00 / $6,342.00	Facility		$665.00	$1,463.00	$6,342.00
United Facility/Professional Professional Modifier Low / Median / High Price $263.75 / $492.39 / $1,004.63	Professional		$263.75	$492.39	$1,004.63