Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.87 / $166.57 / $229.05	Professional		$130.87	$166.57	$229.05
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $121.23 / $147.21 / $200.21	Professional		$121.23	$147.21	$200.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $244.21 / $290.01 / $483.71	Facility		$244.21	$290.01	$483.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.13 / $189.63 / $357.17	Professional		$130.13	$189.63	$357.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.38 / $212.24 / $303.43	Professional		$162.38	$212.24	$303.43
United Facility/Professional Facility Modifier Low / Median / High Price $71.00 / $100.00 / $598.00	Facility		$71.00	$100.00	$598.00
United Facility/Professional Professional Modifier Low / Median / High Price $140.34 / $193.35 / $337.64	Professional		$140.34	$193.35	$337.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $129.75 / $204.01 / $252.74	Professional		$129.75	$204.01	$252.74