Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $762.88 / $762.88 / $762.88	Facility		$762.88	$762.88	$762.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $735.95 / $762.88 / $762.88	Professional		$735.95	$762.88	$762.88
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $403.61 / $403.61 / $403.61	Professional		$403.61	$403.61	$403.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $762.88 / $762.88 / $762.88	Facility		$762.88	$762.88	$762.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $762.88 / $762.88 / $762.88	Professional		$762.88	$762.88	$762.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,605.53 / $1,797.75 / $1,997.50	Professional		$1,605.53	$1,797.75	$1,997.50
United Facility/Professional Professional Modifier Low / Median / High Price $1,997.50 / $1,997.50 / $2,107.36	Professional		$1,997.50	$1,997.50	$2,107.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $919.55 / $919.55 / $919.55	Professional		$919.55	$919.55	$919.55