Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.14 / $202.92 / $394.38	Professional		$116.14	$202.92	$394.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $129.02 / $135.74 / $214.79	Professional		$129.02	$135.74	$214.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $1,441.78 / $1,870.84	Facility		$376.00	$1,441.78	$1,870.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.89 / $203.36 / $400.15	Professional		$117.89	$203.36	$400.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $189.81 / $261.52 / $387.44	Professional		$189.81	$261.52	$387.44
United Facility/Professional Facility Modifier Low / Median / High Price $418.00 / $453.00 / $1,330.00	Facility		$418.00	$453.00	$1,330.00
United Facility/Professional Professional Modifier Low / Median / High Price $173.33 / $239.11 / $448.45	Professional		$173.33	$239.11	$448.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $157.86 / $256.61 / $316.35	Professional		$157.86	$256.61	$316.35