Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.74 / $153.71 / $435.28	Professional		$92.74	$153.71	$435.28
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $109.68 / $110.28 / $123.51	Professional		$109.68	$110.28	$123.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $350.97 / $507.00 / $641.21	Facility		$350.97	$507.00	$641.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.11 / $168.54 / $333.30	Professional		$100.11	$168.54	$333.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $163.63 / $212.17 / $337.29	Professional		$163.63	$212.17	$337.29
United Facility/Professional Facility Modifier Low / Median / High Price $123.00 / $123.00 / $158.00	Facility		$123.00	$123.00	$158.00
United Facility/Professional Professional Modifier Low / Median / High Price $126.87 / $193.03 / $327.92	Professional		$126.87	$193.03	$327.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $164.47 / $189.14 / $233.77	Professional		$164.47	$189.14	$233.77