Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $892.83 / $1,785.57 / $4,100.00	Facility		$892.83	$1,785.57	$4,100.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $574.76 / $574.76 / $669.62	Facility	54	$574.76	$574.76	$669.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $517.96 / $766.34 / $892.83	Professional		$517.96	$766.34	$892.83
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $539.47 / $574.76 / $669.62	Professional	54	$539.47	$574.76	$669.62
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $107.89 / $114.95 / $133.91	Professional	55	$107.89	$114.95	$133.91
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $642.66 / $854.75 / $2,058.00	Professional		$642.66	$854.75	$2,058.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $552.78 / $728.72 / $1,845.61	Professional		$552.78	$728.72	$1,845.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $723.74 / $838.01 / $1,600.08	Professional		$723.74	$838.01	$1,600.08
United Facility/Professional Facility Modifier Low / Median / High Price $808.00 / $1,171.00 / $26,408.00	Facility		$808.00	$1,171.00	$26,408.00
United Facility/Professional Professional Modifier Low / Median / High Price $508.02 / $807.22 / $1,897.97	Professional		$508.02	$807.22	$1,897.97