Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $380.19 / $724.44	Professional		$165.96	$380.19	$724.44
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $177.83 / $223.87	Professional		$158.49	$177.83	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Facility		$331.13	$331.13	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $389.05 / $758.58	Professional		$169.82	$389.05	$758.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $446.68 / $741.31	Professional		$331.13	$446.68	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Facility		$426.58	$426.58	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $354.81 / $741.31	Professional		$154.88	$354.81	$741.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $501.19 / $602.56	Professional		$363.08	$501.19	$602.56