Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $165.96 / $407.38	Professional		$104.71	$165.96	$407.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $128.82 / $154.88	Professional		$114.82	$128.82	$154.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $186.21 / $371.54	Professional		$114.82	$186.21	$371.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $208.93 / $309.03	Professional		$154.88	$208.93	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $165.96 / $281.84	Professional		$107.15	$165.96	$281.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $234.42 / $269.15	Professional		$144.54	$234.42	$269.15