Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $158.49 / $223.87	Professional		$128.82	$158.49	$223.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $147.91 / $165.96	Professional		$131.83	$147.91	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $114.82 / $323.59	Professional		$95.50	$114.82	$323.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $213.80 / $275.42	Professional		$186.21	$213.80	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $141.25	Facility		$77.62	$77.62	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $83.18 / $151.36	Professional		$77.62	$83.18	$151.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $147.91 / $147.91	Professional		$93.33	$147.91	$147.91