Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $214.89 / $975.85 / $3,478.96	Facility		$214.89	$975.85	$3,478.96
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $232.80 / $765.10 / $2,297.48	Facility	52	$232.80	$765.10	$2,297.48
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $107.83 / $193.03 / $280.58	Facility	53	$107.83	$193.03	$280.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.68 / $389.25 / $1,368.00	Professional		$186.68	$389.25	$1,368.00
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $41.98 / $104.94 / $287.17	Professional	53	$41.98	$104.94	$287.17
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $200.76 / $211.87 / $365.29	Professional		$200.76	$211.87	$365.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $437.79 / $516.15 / $867.13	Facility		$437.79	$516.15	$867.13
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $248.66 / $248.66 / $248.66	Facility	52	$248.66	$248.66	$248.66
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $62.17 / $62.17 / $62.17	Facility	53	$62.17	$62.17	$62.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.62 / $342.83 / $610.16	Professional		$190.62	$342.83	$610.16
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $116.81 / $136.51 / $320.00	Professional	53	$116.81	$136.51	$320.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $282.27 / $413.61 / $602.50	Professional		$282.27	$413.61	$602.50
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $282.27 / $413.61 / $602.50	Professional	53	$282.27	$413.61	$602.50
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 $222.83 / $375.91 / $599.75	Professional		$222.83	$375.91	$599.75
United Facility/Professional Professional Modifier 53 Low / Median / High Price $186.80 / $186.80 / $267.31	Professional	53	$186.80	$186.80	$267.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $298.64 / $402.88 / $497.84	Professional		$298.64	$402.88	$497.84
Wellpoint Facility/Professional Professional Modifier 53 Low / Median / High Price $201.68 / $224.24 / $249.15	Professional	53	$201.68	$224.24	$249.15