Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $134.90	Professional		$109.65	$109.65	$134.90
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Professional		$316.23	$316.23	$316.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $128.82	Professional		$109.65	$109.65	$128.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $1,513.56	Professional		$131.83	$181.97	$1,513.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Facility		$1,659.59	$1,659.59	$1,659.59
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $204.17 / $1,659.59	Professional		$125.89	$204.17	$1,659.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $173.78 / $204.17	Professional		$151.36	$173.78	$204.17