Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.84 / $164.84 / $164.84	Facility		$164.84	$164.84	$164.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $177.79	Professional		$161.62	$161.62	$177.79
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $164.16 / $164.16 / $164.16	Professional		$164.16	$164.16	$164.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $161.62 / $161.62	Facility		$161.62	$161.62	$161.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $205.84	Professional		$161.62	$161.62	$205.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $137.38 / $161.62 / $229.40	Professional		$137.38	$161.62	$229.40
United Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $170.51	Professional		$161.62	$161.62	$170.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $171.81 / $171.81 / $211.72	Professional		$171.81	$171.81	$211.72