Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $269.15 / $489.78	Professional		$218.78	$269.15	$489.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $257.04 / $371.54	Professional		$234.42	$257.04	$371.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $575.44 / $630.96	Facility		$416.87	$575.44	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $288.40 / $524.81	Professional		$223.87	$288.40	$524.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $251.19 / $354.81	Professional		$190.55	$251.19	$354.81
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 $204.17 / $275.42 / $489.78	Professional		$204.17	$275.42	$489.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $281.84 / $323.59	Professional		$199.53	$281.84	$323.59