Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $162.18 / $257.04	Professional		$134.90	$162.18	$257.04
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $213.80	Professional		$162.18	$162.18	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $194.98	Professional		$144.54	$144.54	$194.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $309.03 / $467.74	Professional		$218.78	$309.03	$467.74
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $229.09 / $234.42	Facility		$138.04	$229.09	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $158.49 / $239.88	Professional		$138.04	$158.49	$239.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $257.04	Professional		$186.21	$186.21	$257.04