Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $159.55 / $1,614.00 / $4,100.00	Facility		$159.55	$1,614.00	$4,100.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $224.76 / $224.76 / $290.52	Facility	54	$224.76	$224.76	$290.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $243.80 / $299.68 / $387.36	Professional		$243.80	$299.68	$387.36
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $211.13 / $224.76 / $290.52	Professional	54	$211.13	$224.76	$290.52
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $42.23 / $44.95 / $58.10	Professional	55	$42.23	$44.95	$58.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $251.10 / $433.24 / $2,058.00	Professional		$251.10	$433.24	$2,058.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.96 / $449.67 / $798.71	Professional		$234.96	$449.67	$798.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $310.08 / $359.05 / $692.46	Professional		$310.08	$359.05	$692.46
United Facility/Professional Facility Modifier Low / Median / High Price $665.00 / $762.00 / $6,342.00	Facility		$665.00	$762.00	$6,342.00
United Facility/Professional Professional Modifier Low / Median / High Price $261.13 / $337.93 / $821.38	Professional		$261.13	$337.93	$821.38