Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.92 / $182.52 / $290.64	Professional		$80.92	$182.52	$290.64
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $87.71 / $91.63 / $145.84	Professional		$87.71	$91.63	$145.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.86 / $138.11 / $629.00	Facility		$121.86	$138.11	$629.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.25 / $194.26 / $362.90	Professional		$83.25	$194.26	$362.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $150.05 / $232.91 / $345.80	Professional		$150.05	$232.91	$345.80
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 $167.68 / $216.24 / $366.14	Professional		$167.68	$216.24	$366.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.70 / $230.07 / $283.67	Professional		$66.70	$230.07	$283.67