Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $123.03 / $239.88	Professional		$102.33	$123.03	$239.88
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 $190.55 / $575.44 / $630.96	Facility		$190.55	$575.44	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $131.83 / $245.47	Professional		$102.33	$131.83	$245.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $114.82 / $165.96	Professional		$87.10	$114.82	$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 $93.33 / $128.82 / $223.87	Professional		$93.33	$128.82	$223.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $151.36	Professional		$91.20	$131.83	$151.36