Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $151.36 / $323.59	Professional		$91.20	$151.36	$323.59
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $109.65 / $138.04	Professional		$97.72	$109.65	$138.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $512.86 / $645.65	Facility		$354.81	$512.86	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $165.96 / $323.59	Professional		$100.00	$165.96	$323.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $194.98 / $302.00	Professional		$165.96	$194.98	$302.00
United Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $123.03 / $158.49	Facility		$91.20	$123.03	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $162.18 / $281.84	Professional		$91.20	$162.18	$281.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $199.53 / $263.03	Professional		$165.96	$199.53	$263.03