Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $650.04 / $650.04 / $650.04	Facility		$650.04	$650.04	$650.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.65 / $109.82 / $160.59	Professional		$78.65	$109.82	$160.59
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $120.21 / $137.04 / $220.32	Professional		$120.21	$137.04	$220.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.66 / $102.06 / $192.05	Facility		$78.66	$102.06	$192.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.66 / $156.59 / $235.09	Professional		$78.66	$156.59	$235.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $148.41 / $185.51 / $222.62	Professional		$148.41	$185.51	$222.62
United Facility/Professional Professional Modifier Low / Median / High Price $62.33 / $89.05 / $125.30	Professional		$62.33	$89.05	$125.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.88 / $74.20 / $145.66	Professional		$57.88	$74.20	$145.66