Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $691.83 / $741.31	Facility		$57.54	$691.83	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $58.88 / $331.13	Professional		$57.54	$58.88	$331.13
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Professional		$57.54	$57.54	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $74.13	Professional		$57.54	$57.54	$74.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $57.54 / $234.42	Professional		$48.98	$57.54	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Facility		$57.54	$57.54	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $64.57 / $85.11	Professional		$61.66	$64.57	$85.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28