Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.49 / $294.77 / $430.88	Professional		$83.49	$294.77	$430.88
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $89.18 / $89.18 / $122.18	Professional		$89.18	$89.18	$122.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $122.49 / $140.15 / $629.00	Facility		$122.49	$140.15	$629.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.33 / $230.91 / $610.91	Professional		$87.33	$230.91	$610.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $253.26 / $397.04 / $646.59	Professional		$253.26	$397.04	$646.59
United Facility/Professional Facility Modifier Low / Median / High Price $71.00 / $100.00 / $598.00	Facility		$71.00	$100.00	$598.00
United Facility/Professional Professional Modifier Low / Median / High Price $95.03 / $360.36 / $606.92	Professional		$95.03	$360.36	$606.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $292.20 / $388.33 / $477.31	Professional		$292.20	$388.33	$477.31