Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.35 / $109.70 / $203.63	Professional		$52.35	$109.70	$203.63
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $58.73 / $64.02 / $81.95	Professional		$58.73	$64.02	$81.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $507.00 / $507.00 / $641.21	Facility		$507.00	$507.00	$641.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.05 / $105.91 / $217.13	Professional		$55.05	$105.91	$217.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.17 / $144.69 / $224.13	Professional		$112.17	$144.69	$224.13
United Facility/Professional Facility Modifier Low / Median / High Price $36.00 / $41.00 / $128.00	Facility		$36.00	$41.00	$128.00
United Facility/Professional Professional Modifier Low / Median / High Price $94.29 / $145.66 / $265.08	Professional		$94.29	$145.66	$265.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.17 / $129.00 / $160.26	Professional		$112.17	$129.00	$160.26