Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $177.83 / $288.40	Professional		$151.36	$177.83	$288.40
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $234.42	Professional		$181.97	$181.97	$234.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Facility		$218.78	$218.78	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $218.78	Professional		$162.18	$162.18	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $346.74 / $512.86	Professional		$239.88	$346.74	$512.86
United Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $239.88 / $245.47	Facility		$190.55	$239.88	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $173.78 / $269.15	Professional		$151.36	$173.78	$269.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $288.40	Professional		$190.55	$190.55	$288.40