Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $870.96 / $933.25	Facility		$104.71	$870.96	$933.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $1,513.56	Professional		$104.71	$104.71	$1,513.56
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $229.09	Facility		$134.90	$134.90	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $107.15	Professional		$104.71	$104.71	$107.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $104.71 / $380.19	Professional		$89.13	$104.71	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $165.96	Facility		$104.71	$104.71	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $114.82 / $165.96	Professional		$104.71	$114.82	$165.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $134.90	Professional		$104.71	$134.90	$134.90