Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $165.96 / $275.42	Professional		$147.91	$165.96	$275.42
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 $186.21 / $186.21 / $186.21	Professional		$186.21	$186.21	$186.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $186.21 / $199.53	Professional		$158.49	$186.21	$199.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Professional		$134.90	$134.90	$134.90