Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.91 / $145.40 / $209.67	Professional		$103.91	$145.40	$209.67
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $105.80 / $116.06 / $157.84	Professional		$105.80	$116.06	$157.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $102.74 / $437.00	Facility		$89.13	$102.74	$437.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.62 / $167.75 / $325.64	Professional		$108.62	$167.75	$325.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $132.44 / $182.12 / $276.83	Professional		$132.44	$182.12	$276.83
United Facility/Professional Facility Modifier Low / Median / High Price $71.00 / $108.00 / $598.00	Facility		$71.00	$108.00	$598.00
United Facility/Professional Professional Modifier Low / Median / High Price $132.44 / $182.12 / $331.70	Professional		$132.44	$182.12	$331.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $131.88 / $176.90 / $218.77	Professional		$131.88	$176.90	$218.77