Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $645.65	Professional		$128.82	$162.18	$645.65
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $138.04 / $213.80	Professional		$125.89	$138.04	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $138.04 / $346.74	Professional		$95.50	$138.04	$346.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $208.93 / $331.13	Professional		$173.78	$208.93	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $131.83	Facility		$72.44	$72.44	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $154.88 / $275.42	Professional		$104.71	$154.88	$275.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $169.82 / $169.82	Professional		$87.10	$169.82	$169.82