Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.29 / $203.75 / $899.03	Facility		$59.29	$203.75	$899.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.40 / $152.85 / $432.39	Professional		$107.40	$152.85	$432.39
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $123.10 / $125.22 / $159.03	Professional		$123.10	$125.22	$159.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $96.20 / $641.21	Facility		$50.00	$96.20	$641.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.68 / $190.91 / $357.24	Professional		$119.68	$190.91	$357.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $184.47 / $241.00 / $348.59	Professional		$184.47	$241.00	$348.59
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 $138.37 / $191.50 / $353.24	Professional		$138.37	$191.50	$353.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $164.96 / $214.84 / $263.52	Professional		$164.96	$214.84	$263.52