Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $147.91 / $363.08	Facility		$112.20	$147.91	$363.08
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $138.04 / $138.04 / $489.78	Facility	25	$138.04	$138.04	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $165.96 / $398.11	Professional		$85.11	$165.96	$398.11
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $95.50 / $199.53 / $457.09	Professional	25	$95.50	$199.53	$457.09
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $123.03 / $181.97	Professional		$102.33	$123.03	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $144.54 / $186.21	Facility		$120.23	$144.54	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $263.03	Professional		$112.20	$158.49	$263.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $213.80 / $288.40	Professional		$134.90	$213.80	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $95.50 / $141.25	Facility		$70.79	$95.50	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $141.25 / $229.09	Professional		$91.20	$141.25	$229.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $186.21 / $281.84	Professional		$147.91	$186.21	$281.84