Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $104.71 / $181.97	Professional		$83.18	$104.71	$181.97
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $144.54	Professional		$114.82	$114.82	$144.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Facility		$147.91	$147.91	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $147.91	Professional		$109.65	$109.65	$147.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $208.93 / $316.23	Professional		$147.91	$208.93	$316.23
United Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $91.20 / $141.25	Facility		$63.10	$91.20	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $102.33 / $162.18	Professional		$85.11	$102.33	$162.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $173.78	Professional		$112.20	$112.20	$173.78