Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.72 / $179.51 / $196.59	Professional		$38.72	$179.51	$196.59
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $37.33 / $52.74	Professional		$35.72	$37.33	$52.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $350.42 / $350.42 / $350.42	Facility		$350.42	$350.42	$350.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.34 / $84.85 / $299.64	Professional		$33.34	$84.85	$299.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $108.50 / $186.62 / $338.97	Professional		$108.50	$186.62	$338.97
United Facility/Professional Professional Modifier Low / Median / High Price $143.69 / $188.80 / $304.12	Professional		$143.69	$188.80	$304.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $133.30 / $133.30 / $205.29	Professional		$133.30	$133.30	$205.29