Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.53 / $261.12 / $542.64	Facility		$87.53	$261.12	$542.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.03 / $199.84 / $559.85	Professional		$70.03	$199.84	$559.85
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $35.02 / $104.45 / $245.14	Professional	52	$35.02	$104.45	$245.14
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $62.94 / $67.47 / $86.36	Professional		$62.94	$67.47	$86.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.13 / $110.13 / $110.13	Facility		$110.13	$110.13	$110.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.70 / $189.74 / $404.71	Professional		$66.70	$189.74	$404.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $176.24 / $254.83 / $443.78	Professional		$176.24	$254.83	$443.78
United Facility/Professional Professional Modifier Low / Median / High Price $168.84 / $238.56 / $388.25	Professional		$168.84	$238.56	$388.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $167.19 / $227.17 / $279.95	Professional		$167.19	$227.17	$279.95