Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.59 / $168.13 / $478.33	Facility		$164.59	$168.13	$478.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $171.23 / $5,013.45	Professional		$164.59	$171.23	$5,013.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $164.59 / $267.95 / $604.04	Facility		$164.59	$267.95	$604.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $164.59	Professional		$164.59	$164.59	$164.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $164.59 / $164.59 / $322.60	Facility		$164.59	$164.59	$322.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $155.27 / $155.27 / $164.59	Facility		$155.27	$155.27	$164.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $164.59	Professional		$164.59	$164.59	$164.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.49 / $520.00 / $767.00	Professional		$170.49	$520.00	$767.00
United Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $214.89	Professional		$164.59	$164.59	$214.89