Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $141.25 / $275.42	Professional		$52.48	$141.25	$275.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $56.23 / $69.18	Professional		$47.86	$56.23	$69.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $141.25 / $309.03	Professional		$52.48	$141.25	$309.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $190.55 / $281.84	Professional		$144.54	$190.55	$281.84
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Facility		$707.95	$707.95	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $114.82 / $251.19	Professional		$47.86	$114.82	$251.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $213.80 / $251.19	Professional		$40.74	$213.80	$251.19