Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $100.00 / $162.18	Professional		$83.18	$100.00	$162.18
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $131.83	Professional		$107.15	$107.15	$131.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $67.61	Professional		$57.54	$57.54	$67.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $194.98 / $288.40	Professional		$134.90	$194.98	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $131.83 / $134.90	Facility		$114.82	$131.83	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $97.72 / $151.36	Professional		$85.11	$97.72	$151.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $117.49 / $134.90	Professional		$104.71	$117.49	$134.90