Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.29 / $113.81 / $521.86	Facility		$77.29	$113.81	$521.86
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $98.00 / $98.00 / $163.27	Facility	25	$98.00	$98.00	$163.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.67 / $119.82 / $300.00	Professional		$63.67	$119.82	$300.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $59.06 / $135.33 / $370.93	Professional	25	$59.06	$135.33	$370.93
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.50 / $94.50 / $94.50	Professional	50	$94.50	$94.50	$94.50
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $65.77 / $84.74 / $126.70	Professional		$65.77	$84.74	$126.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $145.00 / $245.35	Facility		$120.00	$145.00	$245.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.03 / $122.42 / $201.93	Professional		$79.03	$122.42	$201.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $113.44 / $158.94 / $220.27	Professional		$113.44	$158.94	$220.27
United Facility/Professional Professional Modifier Low / Median / High Price $68.18 / $107.51 / $178.54	Professional		$68.18	$107.51	$178.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $99.39 / $133.26 / $199.89	Professional		$99.39	$133.26	$199.89