Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $275.42 / $630.96	Professional		$134.90	$275.42	$630.96
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $134.90 / $162.18	Professional		$120.23	$134.90	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $316.23 / $758.58	Professional		$134.90	$316.23	$758.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $501.19 / $691.83	Professional		$371.54	$501.19	$691.83
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $263.03 / $575.44	Professional		$125.89	$263.03	$575.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $562.34 / $630.96	Professional		$275.42	$562.34	$630.96