Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $204.17 / $389.05	Professional		$112.20	$204.17	$389.05
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $117.49 / $141.25	Professional		$104.71	$117.49	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Facility		$660.69	$660.69	$660.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $218.78 / $436.52	Professional		$107.15	$218.78	$436.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $309.03 / $524.81	Professional		$234.42	$309.03	$524.81
United Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Facility		$426.58	$426.58	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $194.98 / $371.54	Professional		$100.00	$194.98	$371.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $316.23 / $426.58	Professional		$165.96	$316.23	$426.58