Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $125.89 / $489.78	Professional		$93.33	$125.89	$489.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $117.49 / $173.78	Professional		$107.15	$117.49	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $218.78	Professional		$95.50	$134.90	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $123.03 / $173.78	Professional		$95.50	$123.03	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $204.17	Professional		$95.50	$128.82	$204.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $141.25 / $165.96	Professional		$117.49	$141.25	$165.96