Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $218.78 / $812.83	Professional		$162.18	$218.78	$812.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $281.84	Professional		$245.47	$245.47	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $234.42	Professional		$169.82	$169.82	$234.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $407.38 / $616.60	Professional		$288.40	$407.38	$616.60
United Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $177.83 / $275.42	Facility		$114.82	$177.83	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $199.53 / $323.59	Professional		$151.36	$199.53	$323.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $218.78 / $338.84	Professional		$40.74	$218.78	$338.84