Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $323.59	Professional		$190.55	$190.55	$323.59
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Professional		$169.82	$169.82	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $190.55 / $199.53	Professional		$162.18	$190.55	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $190.55 / $204.17	Professional		$162.18	$190.55	$204.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55