Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $331.13 / $870.96	Facility		$93.33	$331.13	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $257.04 / $363.08	Professional		$245.47	$257.04	$363.08
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $302.00 / $380.19	Professional		$257.04	$302.00	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $302.00 / $309.03	Facility		$257.04	$302.00	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $263.03 / $309.03	Professional		$257.04	$263.03	$309.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Professional		$38.90	$38.90	$38.90