Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $117.49 / $295.12	Facility		$67.61	$117.49	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $177.83 / $416.87	Professional		$125.89	$177.83	$416.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $218.78	Professional		$165.96	$165.96	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $245.47	Facility		$218.78	$218.78	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $218.78	Professional		$158.49	$158.49	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $316.23 / $478.63	Professional		$218.78	$316.23	$478.63
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $151.36 / $234.42	Facility		$104.71	$151.36	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $154.88 / $245.47	Professional		$138.04	$154.88	$245.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $186.21 / $263.03	Professional		$104.71	$186.21	$263.03