Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.54 / $196.32 / $320.80	Professional		$96.54	$196.32	$320.80
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $104.34 / $108.82 / $172.19	Professional		$104.34	$108.82	$172.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.26 / $148.76 / $629.00	Facility		$131.26	$148.76	$629.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.07 / $217.99 / $396.91	Professional		$99.07	$217.99	$396.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $166.22 / $257.70 / $378.29	Professional		$166.22	$257.70	$378.29
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 $186.51 / $254.95 / $461.61	Professional		$186.51	$254.95	$461.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $170.59 / $254.86 / $314.63	Professional		$170.59	$254.86	$314.63