Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $194.98 / $275.42	Facility		$128.82	$194.98	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $112.20 / $269.15	Professional		$54.95	$112.20	$269.15
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $54.95 / $120.23 / $295.12	Professional	25	$54.95	$120.23	$295.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $95.50 / $95.50 / $234.42	Professional	50	$95.50	$95.50	$234.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $79.43 / $199.53	Professional		$69.18	$79.43	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Facility		$186.21	$186.21	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $112.20 / $234.42	Professional		$69.18	$112.20	$234.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $218.78	Professional		$128.82	$151.36	$218.78
United Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $85.11	Facility		$60.26	$60.26	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $104.71 / $194.98	Professional		$64.57	$104.71	$194.98