Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $251.19 / $398.11	Professional		$199.53	$251.19	$398.11
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $331.13	Professional		$257.04	$257.04	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Facility		$338.84	$338.84	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $338.84	Professional		$245.47	$245.47	$338.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $489.78 / $724.44	Professional		$338.84	$489.78	$724.44
United Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $331.13 / $338.84	Facility		$295.12	$331.13	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $245.47 / $371.54	Professional		$213.80	$245.47	$371.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $407.38	Professional		$269.15	$269.15	$407.38