Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $281.84	Professional		$162.18	$162.18	$281.84
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $194.98	Professional		$138.04	$162.18	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $181.97	Facility		$162.18	$162.18	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $186.21 / $218.78	Professional		$162.18	$186.21	$218.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36