Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $229.09 / $309.03	Professional		$223.87	$229.09	$309.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $288.40	Professional		$223.87	$223.87	$288.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $223.87 / $239.88	Professional		$190.55	$223.87	$239.88
United Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $223.87 / $269.15	Professional		$218.78	$223.87	$269.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Professional		$218.78	$218.78	$218.78