Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $218.78 / $501.19	Professional		$147.91	$218.78	$501.19
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Professional		$186.21	$186.21	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $104.71 / $169.82	Professional		$72.44	$104.71	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $165.96 / $186.21	Professional		$147.91	$165.96	$186.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03