Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.83 / $1,556.00 / $3,175.00	Facility		$141.83	$1,556.00	$3,175.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $173.19 / $173.19 / $173.19	Facility	50	$173.19	$173.19	$173.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.53 / $93.12 / $198.80	Professional		$57.53	$93.12	$198.80
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $64.05 / $64.37 / $1,021.00	Professional		$64.05	$64.37	$1,021.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.97 / $126.06 / $254.71	Professional		$59.97	$126.06	$254.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.16 / $224.71 / $224.71	Professional		$131.16	$224.71	$224.71
United Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $442.00 / $5,940.00	Facility		$165.00	$442.00	$5,940.00
United Facility/Professional Professional Modifier Low / Median / High Price $87.56 / $208.72 / $265.98	Professional		$87.56	$208.72	$265.98