Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $173.78 / $275.42	Professional		$134.90	$173.78	$275.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $223.87	Professional		$173.78	$173.78	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $223.87	Professional		$165.96	$165.96	$223.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $331.13 / $489.78	Professional		$229.09	$331.13	$489.78
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $223.87 / $229.09	Facility		$154.88	$223.87	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $165.96 / $257.04	Professional		$144.54	$165.96	$257.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $275.42	Professional		$181.97	$181.97	$275.42