Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.12 / $87.60 / $159.62	Professional		$87.12	$87.60	$159.62
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $114.00 / $114.00 / $145.52	Professional		$114.00	$114.00	$145.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.95 / $111.95 / $111.95	Facility		$111.95	$111.95	$111.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.72 / $81.72 / $111.95	Professional		$81.72	$81.72	$111.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $149.01 / $212.87 / $306.52	Professional		$149.01	$212.87	$306.52
United Facility/Professional Professional Modifier Low / Median / High Price $75.75 / $106.20 / $169.28	Professional		$75.75	$106.20	$169.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.33 / $107.33 / $149.01	Professional		$107.33	$107.33	$149.01