Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.94 / $197.20 / $630.16	Professional		$127.94	$197.20	$630.16
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $112.98 / $133.24 / $159.81	Professional		$112.98	$133.24	$159.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.85 / $213.55 / $403.84	Professional		$120.85	$213.55	$403.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $201.69 / $264.79 / $447.62	Professional		$201.69	$264.79	$447.62
United Facility/Professional Facility Modifier Low / Median / High Price $701.00 / $701.00 / $701.00	Facility		$701.00	$701.00	$701.00
United Facility/Professional Professional Modifier Low / Median / High Price $173.76 / $244.70 / $402.66	Professional		$173.76	$244.70	$402.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $149.54 / $236.05 / $291.23	Professional		$149.54	$236.05	$291.23