Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.07 / $104.98 / $153.30	Professional		$92.07	$104.98	$153.30
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $125.20 / $125.20 / $139.62	Professional		$125.20	$125.20	$139.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.41 / $134.41 / $134.41	Facility		$134.41	$134.41	$134.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.26 / $114.26 / $154.66	Professional		$114.26	$114.26	$154.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $142.44 / $183.13 / $220.59	Professional		$142.44	$183.13	$220.59
United Facility/Professional Professional Modifier Low / Median / High Price $76.88 / $101.90 / $160.96	Professional		$76.88	$101.90	$160.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $139.66 / $139.66 / $172.96	Professional		$139.66	$139.66	$172.96