Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.78 / $134.56 / $469.00	Professional		$113.78	$134.56	$469.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $230.58 / $243.44 / $418.72	Professional		$230.58	$243.44	$418.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.16 / $162.16 / $162.16	Facility		$162.16	$162.16	$162.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.18 / $171.86 / $324.11	Professional		$119.18	$171.86	$324.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $133.74 / $170.89 / $239.04	Professional		$133.74	$170.89	$239.04
United Facility/Professional Facility Modifier Low / Median / High Price $111.65 / $111.65 / $111.65	Facility		$111.65	$111.65	$111.65
United Facility/Professional Professional Modifier Low / Median / High Price $111.65 / $151.47 / $244.28	Professional		$111.65	$151.47	$244.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $146.36 / $168.31 / $219.54	Professional		$146.36	$168.31	$219.54