Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,875.67 / $6,482.38 / $9,034.54	Facility		$2,875.67	$6,482.38	$9,034.54
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $5,123.83 / $13,647.54 / $13,647.54	Facility	22	$5,123.83	$13,647.54	$13,647.54
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $471.22 / $471.22 / $471.22	Facility	52	$471.22	$471.22	$471.22
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $188.49 / $188.49 / $188.49	Facility	53	$188.49	$188.49	$188.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $632.69 / $859.34 / $2,856.00	Professional		$632.69	$859.34	$2,856.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $704.18 / $757.82 / $1,174.61	Professional		$704.18	$757.82	$1,174.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,529.00 / $3,016.21 / $4,340.00	Facility		$1,529.00	$3,016.21	$4,340.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $594.13 / $594.13 / $594.13	Facility	52	$594.13	$594.13	$594.13
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $148.53 / $148.53 / $148.53	Facility	53	$148.53	$148.53	$148.53
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $74.27 / $74.27 / $74.27	Facility	AS	$74.27	$74.27	$74.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $608.88 / $830.36 / $1,531.84	Professional		$608.88	$830.36	$1,531.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $654.25 / $839.30 / $1,161.11	Professional		$654.25	$839.30	$1,161.11
United Facility/Professional Facility Modifier Low / Median / High Price $1,541.00 / $2,139.00 / $6,125.00	Facility		$1,541.00	$2,139.00	$6,125.00
United Facility/Professional Professional Modifier Low / Median / High Price $573.59 / $774.06 / $1,369.40	Professional		$573.59	$774.06	$1,369.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $531.59 / $804.33 / $981.38	Professional		$531.59	$804.33	$981.38