Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.75 / $140.75 / $163.61	Facility		$140.75	$140.75	$163.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.75 / $154.15 / $239.28	Professional		$140.75	$154.15	$239.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $140.75 / $164.04 / $516.54	Facility		$140.75	$164.04	$516.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.96 / $147.37 / $147.37	Professional		$122.96	$147.37	$147.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $140.75 / $140.75 / $275.87	Facility		$140.75	$140.75	$275.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $161.82 / $161.82 / $161.82	Facility		$161.82	$161.82	$161.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.82 / $161.82 / $161.82	Professional		$161.82	$161.82	$161.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.33 / $150.16 / $154.83	Professional		$37.33	$150.16	$154.83
United Facility/Professional Professional Modifier Low / Median / High Price $144.47 / $173.08 / $200.21	Professional		$144.47	$173.08	$200.21