Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $576.16 / $2,080.00 / $4,100.00	Facility		$576.16	$2,080.00	$4,100.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $392.98 / $392.98 / $432.13	Facility	54	$392.98	$392.98	$432.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $455.06 / $523.97 / $576.16	Professional		$455.06	$523.97	$576.16
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $548.46 / $568.52 / $2,116.00	Professional		$548.46	$568.52	$2,116.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $514.80 / $787.00 / $1,524.94	Professional		$514.80	$787.00	$1,524.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,158.52 / $1,275.48 / $1,275.48	Professional		$1,158.52	$1,275.48	$1,275.48
United Facility/Professional Facility Modifier Low / Median / High Price $808.00 / $1,171.00 / $26,408.00	Facility		$808.00	$1,171.00	$26,408.00
United Facility/Professional Professional Modifier Low / Median / High Price $432.70 / $715.36 / $1,543.37	Professional		$432.70	$715.36	$1,543.37