Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $602.56 / $602.56 / $602.56	Facility	50	$602.56	$602.56	$602.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $208.93 / $562.34	Professional		$114.82	$208.93	$562.34
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $245.47 / $501.19 / $1,445.44	Professional	50	$245.47	$501.19	$1,445.44
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $162.18	Professional		$104.71	$134.90	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $208.93 / $398.11	Professional		$123.03	$208.93	$398.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $234.42 / $354.81	Professional		$177.83	$234.42	$354.81
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $181.97 / $331.13	Professional		$109.65	$181.97	$331.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $263.03 / $316.23	Professional		$169.82	$263.03	$316.23