Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $77.62 / $128.82	Professional		$63.10	$77.62	$128.82
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $102.33	Professional		$77.62	$77.62	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $128.82 / $128.82	Facility		$125.89	$128.82	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $128.82	Professional		$109.65	$109.65	$128.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $147.91 / $223.87	Professional		$104.71	$147.91	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $109.65 / $112.20	Facility		$72.44	$109.65	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $74.13 / $114.82	Professional		$64.57	$74.13	$114.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $123.03	Professional		$87.10	$87.10	$123.03