Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $245.47 / $537.03	Professional		$158.49	$245.47	$537.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $162.18 / $199.53	Professional		$144.54	$162.18	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $134.90	Facility		$50.12	$50.12	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $295.12 / $602.56	Professional		$173.78	$295.12	$602.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $407.38 / $602.56	Professional		$338.84	$407.38	$602.56
United Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $40.74 / $169.82	Facility		$36.31	$40.74	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $257.04 / $501.19	Professional		$151.36	$257.04	$501.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $416.87 / $512.86	Professional		$218.78	$416.87	$512.86