Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.64 / $173.64 / $1,129.39	Facility		$173.64	$173.64	$1,129.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $238.46 / $304.62	Professional		$238.46	$238.46	$304.62
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $173.64 / $173.64 / $238.46	Professional		$173.64	$173.64	$238.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $255.32 / $255.32 / $765.00	Facility		$255.32	$255.32	$765.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $238.46 / $281.20	Professional		$238.46	$238.46	$281.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $202.69 / $238.46 / $1,226.06	Professional		$202.69	$238.46	$1,226.06
United Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $265.45 / $290.92	Professional		$238.46	$265.45	$290.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $234.41 / $255.32 / $312.38	Professional		$234.41	$255.32	$312.38