Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $235.83 / $1,556.00 / $3,175.00	Facility		$235.83	$1,556.00	$3,175.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $165.77 / $165.77 / $176.87	Facility	54	$165.77	$165.77	$176.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.61 / $221.02 / $559.91	Professional		$175.61	$221.02	$559.91
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $165.77 / $165.77 / $176.87	Professional	54	$165.77	$165.77	$176.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $224.79 / $255.99 / $660.00	Professional		$224.79	$255.99	$660.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.73 / $321.08 / $624.62	Professional		$217.73	$321.08	$624.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $495.57 / $527.02 / $527.02	Professional		$495.57	$527.02	$527.02
United Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $549.00 / $5,940.00	Facility		$165.00	$549.00	$5,940.00
United Facility/Professional Professional Modifier Low / Median / High Price $161.00 / $301.81 / $638.08	Professional		$161.00	$301.81	$638.08