Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $181.97 / $457.09	Professional		$151.36	$181.97	$457.09
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $194.98 / $245.47	Professional		$173.78	$194.98	$245.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $457.09	Facility		$446.68	$446.68	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $223.87 / $389.05	Professional		$151.36	$223.87	$389.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $181.97 / $316.23	Professional		$158.49	$181.97	$316.23
United Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $40.74 / $173.78	Facility		$36.31	$40.74	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $208.93 / $363.08	Professional		$147.91	$208.93	$363.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $194.98 / $245.47	Professional		$154.88	$194.98	$245.47