Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $141.25 / $218.78	Professional		$107.15	$141.25	$218.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $186.21	Professional		$158.49	$158.49	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Facility		$158.49	$158.49	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $158.49	Professional		$117.49	$117.49	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $269.15 / $407.38	Professional		$186.21	$269.15	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $181.97 / $186.21	Facility		$162.18	$181.97	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $134.90 / $208.93	Professional		$117.49	$134.90	$208.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $223.87	Professional		$147.91	$147.91	$223.87