Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $112.20	Professional		$81.28	$81.28	$112.20
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $104.71	Professional		$81.28	$81.28	$104.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $81.28 / $87.10	Professional		$69.18	$81.28	$87.10
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $81.28 / $97.72	Professional		$77.62	$81.28	$97.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62