Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $213.80 / $263.03	Professional		$181.97	$213.80	$263.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $218.78 / $245.47	Professional		$199.53	$218.78	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $316.23 / $416.87	Professional		$275.42	$316.23	$416.87
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $114.82 / $208.93	Facility		$104.71	$114.82	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $112.20 / $218.78	Professional		$104.71	$112.20	$218.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $218.78 / $218.78	Professional		$138.04	$218.78	$218.78