Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $229.09 / $489.78	Professional		$169.82	$229.09	$489.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $177.83 / $199.53	Professional		$158.49	$177.83	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $316.23 / $338.84	Facility		$100.00	$316.23	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $194.98 / $380.19	Professional		$147.91	$194.98	$380.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $239.88 / $416.87	Professional		$208.93	$239.88	$416.87
United Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $128.82	Facility		$89.13	$89.13	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $177.83 / $346.74	Professional		$134.90	$177.83	$346.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $218.78 / $295.12	Professional		$154.88	$218.78	$295.12