Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $604.16 / $604.16 / $604.16	Facility	50	$604.16	$604.16	$604.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.59 / $200.83 / $546.53	Professional		$116.59	$200.83	$546.53
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $246.76 / $677.11 / $795.33	Professional	50	$246.76	$677.11	$795.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $105.60 / $143.05 / $164.08	Professional		$105.60	$143.05	$164.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.90 / $130.90 / $130.90	Facility		$130.90	$130.90	$130.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.27 / $210.28 / $398.27	Professional		$123.27	$210.28	$398.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $195.02 / $255.43 / $448.15	Professional		$195.02	$255.43	$448.15
United Facility/Professional Professional Modifier Low / Median / High Price $166.27 / $224.32 / $389.28	Professional		$166.27	$224.32	$389.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $169.42 / $227.71 / $280.80	Professional		$169.42	$227.71	$280.80