Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $134.90	Facility		$87.10	$87.10	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $102.33	Professional		$87.10	$87.10	$102.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $141.25 / $478.63	Facility		$87.10	$141.25	$478.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $87.10	Facility		$83.18	$83.18	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $95.50	Professional		$75.86	$75.86	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $165.96 / $234.42	Facility		$87.10	$165.96	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $112.20	Professional		$87.10	$87.10	$112.20