Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $208.93 / $309.03	Professional		$173.78	$208.93	$309.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $208.93 / $239.88	Professional		$186.21	$208.93	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $181.97 / $338.84	Facility		$28.84	$181.97	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $169.82 / $457.09	Professional		$134.90	$169.82	$457.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $302.00 / $389.05	Professional		$263.03	$302.00	$389.05
United Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $123.03 / $263.03	Facility		$109.65	$123.03	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $117.49 / $234.42	Professional		$109.65	$117.49	$234.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $128.82 / $389.05	Professional		$102.33	$128.82	$389.05