Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $213.80 / $281.84	Professional		$169.82	$213.80	$281.84
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $389.05	Facility		$269.15	$269.15	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $331.13	Professional		$229.09	$229.09	$331.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $363.08 / $426.58	Professional		$275.42	$363.08	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $14.79 / $134.90 / $245.47	Facility		$14.79	$134.90	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $208.93 / $338.84	Professional		$162.18	$208.93	$338.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $323.59	Professional		$251.19	$251.19	$323.59