Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.28 / $215.85 / $5,540.21	Facility		$109.28	$215.85	$5,540.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $315.94	Professional		$108.47	$108.47	$315.94
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $109.29 / $109.29	Professional		$108.47	$109.29	$109.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $136.05 / $136.05 / $163.28	Facility		$136.05	$136.05	$163.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $138.13	Professional		$108.47	$108.47	$138.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $92.20 / $108.47 / $398.20	Professional		$92.20	$108.47	$398.20
United Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $120.75 / $132.33	Professional		$108.47	$120.75	$132.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $124.74 / $136.05 / $147.53	Professional		$124.74	$136.05	$147.53