Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.41 / $82.41 / $82.41	Facility		$82.41	$82.41	$82.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $94.23	Professional		$89.75	$89.75	$94.23
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $66.23 / $66.23 / $66.23	Professional		$66.23	$66.23	$66.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $89.75 / $89.75	Facility		$89.75	$89.75	$89.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $114.30	Professional		$89.75	$89.75	$114.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.29 / $89.75 / $1,500.79	Professional		$76.29	$89.75	$1,500.79
United Facility/Professional Facility Modifier Low / Median / High Price $1,667.54 / $1,667.54 / $1,667.54	Facility		$1,667.54	$1,667.54	$1,667.54
United Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $94.69	Professional		$89.75	$89.75	$94.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $82.41 / $89.75 / $117.57	Professional		$82.41	$89.75	$117.57