Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $190.55 / $309.03	Professional		$147.91	$190.55	$309.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $257.04	Professional		$194.98	$194.98	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $245.47	Professional		$177.83	$177.83	$245.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $371.54 / $562.34	Professional		$263.03	$371.54	$562.34
United Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $173.78 / $269.15	Facility		$120.23	$173.78	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $181.97 / $288.40	Professional		$162.18	$181.97	$288.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $309.03	Professional		$213.80	$213.80	$309.03