Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $784.65 / $784.65 / $1,400.85	Facility		$784.65	$784.65	$1,400.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.91 / $236.58 / $461.30	Professional		$88.91	$236.58	$461.30
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $97.16 / $97.96 / $144.97	Professional		$97.16	$97.96	$144.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $514.04 / $891.79	Facility		$376.00	$514.04	$891.79
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	52	$118.08	$118.08	$118.08
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.52 / $29.52 / $29.52	Facility	53	$29.52	$29.52	$29.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.87 / $214.27 / $463.37	Professional		$90.87	$214.27	$463.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $216.43 / $323.39 / $477.73	Professional		$216.43	$323.39	$477.73
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 $196.97 / $270.05 / $465.41	Professional		$196.97	$270.05	$465.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $173.40 / $311.12 / $383.31	Professional		$173.40	$311.12	$383.31