Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $199.53 / $239.88	Professional		$173.78	$199.53	$239.88
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $199.53 / $223.87	Professional		$177.83	$199.53	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Professional		$131.83	$131.83	$131.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $288.40 / $371.54	Professional		$251.19	$288.40	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $190.55	Facility		$104.71	$104.71	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $112.20 / $199.53	Professional		$104.71	$112.20	$199.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $199.53 / $199.53	Professional		$123.03	$199.53	$199.53