Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.68 / $157.94 / $408.02	Professional		$109.68	$157.94	$408.02
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $132.91 / $137.62 / $188.54	Professional		$132.91	$137.62	$188.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.97 / $109.49 / $629.00	Facility		$93.97	$109.49	$629.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.41 / $177.31 / $340.25	Professional		$115.41	$177.31	$340.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.35 / $194.36 / $276.75	Professional		$141.35	$194.36	$276.75
United Facility/Professional Facility Modifier Low / Median / High Price $158.00 / $330.00 / $1,008.00	Facility		$158.00	$330.00	$1,008.00
United Facility/Professional Professional Modifier Low / Median / High Price $131.46 / $178.87 / $301.82	Professional		$131.46	$178.87	$301.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $127.73 / $189.17 / $233.45	Professional		$127.73	$189.17	$233.45