Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.33 / $192.77 / $195.38	Professional		$169.33	$192.77	$195.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $107.80 / $208.40 / $237.58	Professional		$107.80	$208.40	$237.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.54 / $182.03 / $337.11	Facility		$28.54	$182.03	$337.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.82 / $185.25 / $640.62	Professional		$118.82	$185.25	$640.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $260.50 / $312.60 / $390.75	Professional		$260.50	$312.60	$390.75
United Facility/Professional Facility Modifier Low / Median / High Price $109.41 / $109.41 / $109.41	Facility		$109.41	$109.41	$109.41
United Facility/Professional Professional Modifier Low / Median / High Price $109.41 / $123.74 / $240.96	Professional		$109.41	$123.74	$240.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $101.60 / $104.20 / $130.25	Professional		$101.60	$104.20	$130.25