Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.05 / $218.42 / $365.40	Professional		$108.05	$218.42	$365.40
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $124.93 / $134.15 / $141.91	Professional		$124.93	$134.15	$141.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $50.00 / $158.93	Facility		$50.00	$50.00	$158.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.43 / $220.64 / $413.94	Professional		$103.43	$220.64	$413.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $252.78 / $305.99 / $399.12	Professional		$252.78	$305.99	$399.12
United Facility/Professional Facility Modifier Low / Median / High Price $89.00 / $89.00 / $89.00	Facility		$89.00	$89.00	$89.00
United Facility/Professional Professional Modifier Low / Median / High Price $191.22 / $256.41 / $487.81	Professional		$191.22	$256.41	$487.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $123.70 / $193.52 / $305.99	Professional		$123.70	$193.52	$305.99