Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.96 / $161.96 / $161.96	Facility		$161.96	$161.96	$161.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $217.03	Professional		$165.83	$165.83	$217.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $161.96 / $161.96 / $165.83	Professional		$161.96	$161.96	$165.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $211.20	Professional		$165.83	$165.83	$211.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $177.36	Professional		$165.83	$165.83	$177.36
United Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $198.89	Professional		$165.83	$165.83	$198.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $155.97 / $155.97 / $155.97	Professional		$155.97	$155.97	$155.97