Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $120.23	Professional		$87.10	$87.10	$120.23
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $112.20	Professional		$87.10	$87.10	$112.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $87.10 / $95.50	Professional		$74.13	$87.10	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $87.10 / $104.71	Professional		$85.11	$87.10	$104.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11