Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $966.72 / $1,123.08 / $1,630.56	Professional		$966.72	$1,123.08	$1,630.56
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $1,716.70 / $1,716.70 / $1,716.70	Professional		$1,716.70	$1,716.70	$1,716.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Facility		$75.00	$75.00	$75.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,491.30 / $1,491.30 / $1,491.30	Professional		$1,491.30	$1,491.30	$1,491.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,604.29 / $1,986.77 / $2,723.51	Professional		$1,604.29	$1,986.77	$2,723.51
United Facility/Professional Facility Modifier Low / Median / High Price $117.36 / $869.29 / $1,322.78	Facility		$117.36	$869.29	$1,322.78
United Facility/Professional Professional Modifier Low / Median / High Price $904.78 / $1,213.03 / $1,998.12	Professional		$904.78	$1,213.03	$1,998.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,467.50 / $1,610.31 / $1,610.31	Professional		$1,467.50	$1,610.31	$1,610.31