Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $760.00 / $2,564.52 / $4,469.72	Facility		$760.00	$2,564.52	$4,469.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $515.95 / $1,127.41 / $5,189.60	Professional		$515.95	$1,127.41	$5,189.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,607.69 / $2,607.69 / $2,607.69	Professional	50	$2,607.69	$2,607.69	$2,607.69
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $263.00 / $329.31 / $343.42	Professional	52	$263.00	$329.31	$343.42
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $394.50 / $515.13 / $823.14	Professional	54	$394.50	$515.13	$823.14
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $73.13 / $97.02 / $103.07	Professional	55	$73.13	$97.02	$103.07
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $576.60 / $585.36 / $884.86	Professional		$576.60	$585.36	$884.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $926.00 / $980.44 / $1,205.38	Facility		$926.00	$980.44	$1,205.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.58 / $668.78 / $1,076.00	Professional		$489.58	$668.78	$1,076.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $552.77 / $635.69 / $884.10	Professional		$552.77	$635.69	$884.10
United Facility/Professional Facility Modifier Low / Median / High Price $1,009.00 / $1,009.00 / $4,561.46	Facility		$1,009.00	$1,009.00	$4,561.46
United Facility/Professional Professional Modifier Low / Median / High Price $496.28 / $604.75 / $1,044.09	Professional		$496.28	$604.75	$1,044.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $503.10 / $581.22 / $635.69	Professional		$503.10	$581.22	$635.69