Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $179.04 / $2,761.00 / $4,100.00	Facility		$179.04	$2,761.00	$4,100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.99 / $133.88 / $179.04	Professional		$115.99	$133.88	$179.04
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $105.80 / $116.06 / $573.00	Professional		$105.80	$116.06	$573.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.70 / $165.56 / $408.69	Professional		$109.70	$165.56	$408.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $157.28 / $165.56 / $339.89	Professional		$157.28	$165.56	$339.89
United Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $442.00 / $5,940.00	Facility		$165.00	$442.00	$5,940.00
United Facility/Professional Professional Modifier Low / Median / High Price $129.86 / $179.42 / $413.18	Professional		$129.86	$179.42	$413.18