Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $204.17	Professional		$162.18	$162.18	$204.17
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $181.97	Professional		$162.18	$162.18	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $446.68	Professional		$131.83	$181.97	$446.68
United Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $169.82 / $371.54	Professional		$125.89	$169.82	$371.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $173.78 / $204.17	Professional		$151.36	$173.78	$204.17