Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.76 / $83.76 / $83.76	Facility		$83.76	$83.76	$83.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.63 / $131.11 / $174.81	Professional		$113.63	$131.11	$174.81
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $139.85 / $139.85 / $159.43	Professional		$139.85	$139.85	$159.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.70 / $108.04 / $429.77	Professional		$90.70	$108.04	$429.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $174.81 / $209.77 / $262.22	Professional		$174.81	$209.77	$262.22
United Facility/Professional Facility Modifier Low / Median / High Price $73.42 / $73.42 / $73.42	Facility		$73.42	$73.42	$73.42
United Facility/Professional Professional Modifier Low / Median / High Price $73.42 / $83.45 / $153.83	Professional		$73.42	$83.45	$153.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.41 / $87.41 / $87.41	Professional		$87.41	$87.41	$87.41