Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $758.58 / $1,230.27	Facility		$275.42	$758.58	$1,230.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $616.60 / $1,288.25	Professional		$257.04	$616.60	$1,288.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $275.42 / $436.52	Professional		$245.47	$275.42	$436.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $602.56 / $851.14	Facility		$512.86	$602.56	$851.14
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $524.81 / $524.81 / $524.81	Facility	22	$524.81	$524.81	$524.81
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	52	$346.74	$346.74	$346.74
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $87.10 / $87.10 / $87.10	Facility	53	$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $524.81 / $1,071.52	Professional		$263.03	$524.81	$1,071.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $831.76 / $1,122.02	Professional		$416.87	$831.76	$1,122.02
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $524.81 / $1,318.26	Facility		$416.87	$524.81	$1,318.26
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $549.54 / $1,148.15	Professional		$257.04	$549.54	$1,148.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $891.25 / $1,096.48	Professional		$295.12	$891.25	$1,096.48