Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.49 / $164.42 / $206.85	Facility		$99.49	$164.42	$206.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.42 / $164.42 / $235.16	Professional		$164.42	$164.42	$235.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $164.42 / $191.63 / $603.41	Facility		$164.42	$191.63	$603.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.41 / $190.53 / $190.53	Professional		$152.41	$190.53	$190.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $164.42 / $164.42 / $322.26	Facility		$164.42	$164.42	$322.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $219.62 / $219.62 / $219.62	Facility		$219.62	$219.62	$219.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $219.62 / $219.62 / $219.62	Professional		$219.62	$219.62	$219.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.98 / $173.97 / $237.92	Professional		$47.98	$173.97	$237.92
United Facility/Professional Professional Modifier Low / Median / High Price $164.42 / $205.53 / $235.16	Professional		$164.42	$205.53	$235.16