Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $128.82 / $223.87	Professional		$107.15	$128.82	$223.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $120.23 / $173.78	Professional		$107.15	$120.23	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $575.44 / $630.96	Facility		$194.98	$575.44	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $147.91 / $245.47	Professional		$107.15	$147.91	$245.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $117.49 / $165.96	Professional		$89.13	$117.49	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $380.19 / $1,096.48	Facility		$302.00	$380.19	$1,096.48
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $144.54 / $234.42	Professional		$104.71	$144.54	$234.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $134.90 / $154.88	Professional		$112.20	$134.90	$154.88