Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $199.53 / $316.23	Professional		$158.49	$199.53	$316.23
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 $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $275.42	Professional		$199.53	$199.53	$275.42
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 $239.88 / $275.42 / $281.84	Facility		$239.88	$275.42	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $190.55 / $288.40	Professional		$165.96	$190.55	$288.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $309.03	Professional		$218.78	$218.78	$309.03