Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.94 / $87.28 / $127.80	Facility		$86.94	$87.28	$127.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.94 / $87.28 / $105.20	Professional		$86.94	$87.28	$105.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.28 / $142.09 / $320.32	Facility		$87.28	$142.09	$320.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $87.28	Professional		$87.28	$87.28	$87.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.28 / $87.28 / $171.07	Facility		$87.28	$87.28	$171.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.34 / $82.34 / $87.28	Facility		$82.34	$82.34	$87.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $87.28	Professional		$87.28	$87.28	$87.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.04 / $75.04 / $86.99	Professional		$75.04	$75.04	$86.99
United Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $97.40	Professional		$87.28	$87.28	$97.40