Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,754.40 / $5,754.40 / $5,754.40	Facility		$5,754.40	$5,754.40	$5,754.40
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,023.29 / $1,698.24 / $5,754.40	Facility	50	$1,023.29	$1,698.24	$5,754.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $691.83 / $1,621.81	Professional		$512.86	$691.83	$1,621.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $398.11 / $1,202.26 / $3,388.44	Professional	50	$398.11	$1,202.26	$3,388.44
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $524.81 / $588.84	Professional		$467.74	$524.81	$588.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $630.96 / $1,023.29	Facility		$602.56	$630.96	$1,023.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $602.56 / $1,202.26	Professional		$457.09	$602.56	$1,202.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $758.58 / $1,122.02	Professional		$660.69	$758.58	$1,122.02
United Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,621.81	Facility		$1,000.00	$1,000.00	$1,621.81
United Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $562.34 / $1,047.13	Professional		$407.38	$562.34	$1,047.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $691.83 / $954.99	Professional		$478.63	$691.83	$954.99