Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $114.82 / $977.24	Facility		$63.10	$114.82	$977.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $138.04 / $288.40	Professional		$95.50	$138.04	$288.40
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	25	$123.03	$123.03	$123.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $186.21	Professional		$138.04	$138.04	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $128.82 / $234.42	Professional		$83.18	$128.82	$234.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $151.36 / $199.53	Professional		$112.20	$151.36	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $138.04 / $239.88	Facility		$100.00	$138.04	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $138.04 / $218.78	Professional		$91.20	$138.04	$218.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $199.53 / $251.19	Professional		$131.83	$199.53	$251.19