Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.91 / $158.91 / $158.91	Facility		$158.91	$158.91	$158.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $166.86	Professional		$158.91	$158.91	$166.86
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $137.38 / $137.38 / $137.38	Professional		$137.38	$137.38	$137.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.91 / $152.91 / $158.91	Facility		$152.91	$152.91	$158.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $158.91	Professional		$158.91	$158.91	$158.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $150.97 / $158.91 / $242.88	Professional		$150.97	$158.91	$242.88
United Facility/Professional Professional Modifier Low / Median / High Price $63.57 / $158.91 / $162.91	Professional		$63.57	$158.91	$162.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $148.24 / $183.31	Professional		$131.90	$148.24	$183.31