Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.43 / $95.31 / $155.41	Professional		$83.43	$95.31	$155.41
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $108.51 / $108.93 / $132.87	Professional		$108.51	$108.93	$132.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.62 / $120.62 / $120.62	Facility		$120.62	$120.62	$120.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.05 / $88.05 / $120.62	Professional		$88.05	$88.05	$120.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $136.07 / $194.38 / $279.91	Professional		$136.07	$194.38	$279.91
United Facility/Professional Professional Modifier Low / Median / High Price $87.56 / $98.77 / $153.77	Professional		$87.56	$98.77	$153.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $117.55 / $117.55 / $136.07	Professional		$117.55	$117.55	$136.07