Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.91 / $1,162.28 / $6,992.19	Facility		$131.91	$1,162.28	$6,992.19
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $55.09 / $107.83 / $199.31	Facility	53	$55.09	$107.83	$199.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.76 / $318.99 / $974.54	Professional		$175.76	$318.99	$974.54
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $37.61 / $90.30 / $233.31	Professional	53	$37.61	$90.30	$233.31
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $1,369.00 / $1,369.00 / $1,369.00	Professional		$1,369.00	$1,369.00	$1,369.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $437.79 / $516.15 / $867.13	Facility		$437.79	$516.15	$867.13
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $194.94 / $194.94 / $194.94	Facility	52	$194.94	$194.94	$194.94
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.74 / $48.74 / $48.74	Facility	53	$48.74	$48.74	$48.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.75 / $301.75 / $301.75	Professional		$301.75	$301.75	$301.75
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $94.17 / $94.17 / $174.72	Professional	53	$94.17	$94.17	$174.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $284.66 / $420.90 / $603.15	Professional		$284.66	$420.90	$603.15
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $282.92 / $414.03 / $603.15	Professional	53	$282.92	$414.03	$603.15
United Facility/Professional Facility Modifier Low / Median / High Price $214.00 / $322.00 / $1,008.00	Facility		$214.00	$322.00	$1,008.00
United Facility/Professional Professional Modifier Low / Median / High Price $309.00 / $430.15 / $769.67	Professional		$309.00	$430.15	$769.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $403.36 / $448.48 / $498.31	Professional		$403.36	$448.48	$498.31
Wellpoint Facility/Professional Professional Modifier 53 Low / Median / High Price $201.68 / $224.24 / $249.15	Professional	53	$201.68	$224.24	$249.15