Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.64 / $206.12 / $225.36	Professional		$178.64	$206.12	$225.36
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $274.83 / $302.31 / $344.63	Professional		$274.83	$302.31	$344.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.38 / $169.92 / $675.23	Professional		$142.38	$169.92	$675.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $274.83 / $329.80 / $412.25	Professional		$274.83	$329.80	$412.25
United Facility/Professional Facility Modifier Low / Median / High Price $115.43 / $115.43 / $115.43	Facility		$115.43	$115.43	$115.43
United Facility/Professional Professional Modifier Low / Median / High Price $115.43 / $126.42 / $250.09	Professional		$115.43	$126.42	$250.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $137.41 / $218.49 / $218.49	Professional		$137.41	$218.49	$218.49