Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.27 / $94.00 / $436.67	Facility		$51.27	$94.00	$436.67
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $99.25 / $108.71 / $136.22	Facility	25	$99.25	$108.71	$136.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.34 / $84.60 / $205.00	Professional		$48.34	$84.60	$205.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $47.04 / $92.99 / $236.54	Professional	25	$47.04	$92.99	$236.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $254.64 / $262.68 / $271.76	Professional	50	$254.64	$262.68	$271.76
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $43.11 / $57.48 / $84.62	Professional		$43.11	$57.48	$84.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $145.00 / $245.35	Facility		$110.00	$145.00	$245.35
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $55.05 / $55.05 / $55.05	Facility	62	$55.05	$55.05	$55.05
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $8.81 / $8.81 / $8.81	Facility	AS	$8.81	$8.81	$8.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.87 / $84.70 / $147.84	Professional		$51.87	$84.70	$147.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.88 / $111.49 / $155.75	Professional		$77.88	$111.49	$155.75
United Facility/Professional Professional Modifier Low / Median / High Price $51.30 / $77.48 / $133.78	Professional		$51.30	$77.48	$133.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.45 / $94.62 / $141.93	Professional		$67.45	$94.62	$141.93