Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $851.14 / $851.14 / $851.14	Facility	50	$851.14	$851.14	$851.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $194.98 / $426.58	Professional		$134.90	$194.98	$426.58
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $323.59 / $323.59 / $1,258.93	Professional	50	$323.59	$323.59	$1,258.93
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $134.90 / $158.49	Professional		$120.23	$134.90	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $158.49 / $338.84	Facility		$134.90	$158.49	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $186.21 / $316.23	Professional		$117.49	$186.21	$316.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $186.21 / $323.59	Professional		$162.18	$186.21	$323.59
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 $120.23 / $177.83 / $302.00	Professional		$120.23	$177.83	$302.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $169.82 / $234.42	Professional		$123.03	$169.82	$234.42