Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.11 / $170.03 / $249.57	Professional		$143.11	$170.03	$249.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $335.83 / $335.83 / $335.83	Facility		$335.83	$335.83	$335.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.93 / $269.33 / $612.97	Professional		$26.93	$269.33	$612.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.68 / $214.10 / $362.64	Facility		$26.68	$214.10	$362.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.54 / $214.10 / $313.91	Professional		$28.54	$214.10	$313.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $244.43 / $244.43 / $244.43	Facility		$244.43	$244.43	$244.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.43 / $207.77 / $358.88	Professional		$178.43	$207.77	$358.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $255.23 / $335.83 / $811.00	Professional		$255.23	$335.83	$811.00
United Facility/Professional Professional Modifier Low / Median / High Price $108.59 / $173.42 / $326.05	Professional		$108.59	$173.42	$326.05