Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.65 / $210.66 / $315.99	Professional		$162.65	$210.66	$315.99
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $220.65 / $221.48 / $270.17	Professional		$220.65	$221.48	$270.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $228.90 / $228.90 / $228.90	Facility		$228.90	$228.90	$228.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.57 / $194.57 / $228.90	Professional		$194.57	$194.57	$228.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $276.64 / $395.22 / $569.12	Professional		$276.64	$395.22	$569.12
United Facility/Professional Professional Modifier Low / Median / High Price $178.04 / $197.17 / $308.82	Professional		$178.04	$197.17	$308.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $221.67 / $221.67 / $276.64	Professional		$221.67	$221.67	$276.64